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Caeyenberghs K, Imms P, Irimia A, Monti MM, Esopenko C, de Souza NL, Dominguez D JF, Newsome MR, Dobryakova E, Cwiek A, Mullin HAC, Kim NJ, Mayer AR, Adamson MM, Bickart K, Breedlove KM, Dennis EL, Disner SG, Haswell C, Hodges CB, Hoskinson KR, Johnson PK, Königs M, Li LM, Liebel SW, Livny A, Morey RA, Muir AM, Olsen A, Razi A, Su M, Tate DF, Velez C, Wilde EA, Zielinski BA, Thompson PM, Hillary FG. ENIGMA's simple seven: Recommendations to enhance the reproducibility of resting-state fMRI in traumatic brain injury. Neuroimage Clin 2024; 42:103585. [PMID: 38531165 PMCID: PMC10982609 DOI: 10.1016/j.nicl.2024.103585] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2023] [Revised: 02/22/2024] [Accepted: 02/25/2024] [Indexed: 03/28/2024]
Abstract
Resting state functional magnetic resonance imaging (rsfMRI) provides researchers and clinicians with a powerful tool to examine functional connectivity across large-scale brain networks, with ever-increasing applications to the study of neurological disorders, such as traumatic brain injury (TBI). While rsfMRI holds unparalleled promise in systems neurosciences, its acquisition and analytical methodology across research groups is variable, resulting in a literature that is challenging to integrate and interpret. The focus of this narrative review is to address the primary methodological issues including investigator decision points in the application of rsfMRI to study the consequences of TBI. As part of the ENIGMA Brain Injury working group, we have collaborated to identify a minimum set of recommendations that are designed to produce results that are reliable, harmonizable, and reproducible for the TBI imaging research community. Part one of this review provides the results of a literature search of current rsfMRI studies of TBI, highlighting key design considerations and data processing pipelines. Part two outlines seven data acquisition, processing, and analysis recommendations with the goal of maximizing study reliability and between-site comparability, while preserving investigator autonomy. Part three summarizes new directions and opportunities for future rsfMRI studies in TBI patients. The goal is to galvanize the TBI community to gain consensus for a set of rigorous and reproducible methods, and to increase analytical transparency and data sharing to address the reproducibility crisis in the field.
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Affiliation(s)
- Karen Caeyenberghs
- Cognitive Neuroscience Unit, School of Psychology, Deakin University, Geelong, Australia.
| | - Phoebe Imms
- Ethel Percy Andrus Gerontology Center, Leonard Davis School of Gerontology, University of Southern California, Los Angeles, CA, USA.
| | - Andrei Irimia
- Ethel Percy Andrus Gerontology Center, Leonard Davis School of Gerontology, University of Southern California, Los Angeles, CA, USA; Alfred E. Mann Department of Biomedical Engineering, Andrew & Erna Viterbi School of Engineering, University of Southern California, Los Angeles, CA, USA; Department of Quantitative & Computational Biology, Dana and David Dornsife College of Arts & Sciences, University of Southern California, Los Angeles, CA, USA.
| | - Martin M Monti
- Department of Psychology, UCLA, USA; Brain Injury Research Center (BIRC), Department of Neurosurgery, UCLA, USA.
| | - Carrie Esopenko
- Department of Rehabilitation and Human Performance, Icahn School of Medicine at Mount Sinai, NY, USA.
| | - Nicola L de Souza
- Department of Rehabilitation and Human Performance, Icahn School of Medicine at Mount Sinai, NY, USA.
| | - Juan F Dominguez D
- Cognitive Neuroscience Unit, School of Psychology, Deakin University, Geelong, Australia.
| | - Mary R Newsome
- Michael E. DeBakey VA Medical Center, Houston, TX, USA; H. Ben Taub Department of Physical Medicine and Rehabilitation, Baylor College of Medicine, Houston, TX, USA; TBI and Concussion Center, Department of Neurology, University of Utah, Salt Lake City, UT, USA.
| | - Ekaterina Dobryakova
- Center for Traumatic Brain Injury, Kessler Foundation, East Hanover, NJ, USA; Rutgers New Jersey Medical School, Newark, NJ, USA.
| | - Andrew Cwiek
- Department of Psychology, Penn State University, State College, PA, USA.
| | - Hollie A C Mullin
- Department of Psychology, Penn State University, State College, PA, USA.
| | - Nicholas J Kim
- Ethel Percy Andrus Gerontology Center, Leonard Davis School of Gerontology, University of Southern California, Los Angeles, CA, USA; Alfred E. Mann Department of Biomedical Engineering, Andrew & Erna Viterbi School of Engineering, University of Southern California, Los Angeles, CA, USA.
| | - Andrew R Mayer
- Mind Research Network, Albuquerque, NM, USA; Departments of Neurology and Psychiatry, University of New Mexico School of Medicine, Albuquerque, NM, USA.
| | - Maheen M Adamson
- Women's Operational Military Exposure Network (WOMEN) & Rehabilitation Department, VA Palo Alto, Palo Alto, CA, USA; Rehabilitation Service, VA Palo Alto, Palo Alto, CA, USA; Neurosurgery, Stanford School of Medicine, Stanford, CA, USA.
| | - Kevin Bickart
- UCLA Steve Tisch BrainSPORT Program, USA; Department of Neurology, David Geffen School of Medicine at UCLA, USA.
| | - Katherine M Breedlove
- Center for Clinical Spectroscopy, Brigham and Women's Hospital, Boston, MA, USA; Department of Radiology, Harvard Medical School, Boston, MA, USA.
| | - Emily L Dennis
- TBI and Concussion Center, Department of Neurology, University of Utah, Salt Lake City, UT, USA; George E. Wahlen Veterans Affairs Medical Center, Salt Lake City, UT, USA.
| | - Seth G Disner
- Minneapolis VA Health Care System, Minneapolis, MN, USA; Department of Psychiatry and Behavioral Sciences, University of Minnesota Medical School, Minneapolis, MN, USA.
| | - Courtney Haswell
- Department of Psychiatry and Behavioral Sciences, Duke University, Durham, NC, USA.
| | - Cooper B Hodges
- TBI and Concussion Center, Department of Neurology, University of Utah, Salt Lake City, UT, USA; George E. Wahlen Veterans Affairs Medical Center, Salt Lake City, UT, USA; Department of Psychology, Brigham Young University, Provo, UT, USA.
| | - Kristen R Hoskinson
- Center for Biobehavioral Health, The Abigail Wexner Research Institute at Nationwide Children's Hospital, Columbus, OH, USA; Department of Pediatrics, The Ohio State University College of Medicine, OH, USA.
| | - Paula K Johnson
- TBI and Concussion Center, Department of Neurology, University of Utah, Salt Lake City, UT, USA; Neuroscience Center, Brigham Young University, Provo, UT, USA.
| | - Marsh Königs
- Emma Children's Hospital, Amsterdam UMC, University of Amsterdam, Emma Neuroscience Group, The Netherlands; Amsterdam Reproduction and Development, Amsterdam, The Netherlands.
| | - Lucia M Li
- C3NL, Imperial College London, United Kingdom; UK DRI Centre for Health Care and Technology, Imperial College London, United Kingdom.
| | - Spencer W Liebel
- TBI and Concussion Center, Department of Neurology, University of Utah, Salt Lake City, UT, USA; George E. Wahlen Veterans Affairs Medical Center, Salt Lake City, UT, USA.
| | - Abigail Livny
- Division of Diagnostic Imaging, Sheba Medical Center, Tel-Hashomer, Israel; Sagol School of Neuroscience, Tel-Aviv University, Tel-Aviv, Israel; Sackler Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Israel.
| | - Rajendra A Morey
- Department of Psychiatry and Behavioral Sciences, Duke University, Durham, NC, USA; Duke-UNC Brain Imaging and Analysis Center, Duke University, Durham, NC, USA; VA Mid-Atlantic Mental Illness Research Education and Clinical Center, Durham, NC, USA.
| | - Alexandra M Muir
- Department of Psychology, Brigham Young University, Provo, UT, USA.
| | - Alexander Olsen
- Department of Psychology, Norwegian University of Science and Technology, Trondheim, Norway; Clinic of Rehabilitation, St. Olavs Hospital, Trondheim University Hospital, Trondheim, Norway; NorHEAD - Norwegian Centre for Headache Research, Norwegian University of Science and Technology, Trondheim, Norway.
| | - Adeel Razi
- Turner Institute for Brain and Mental Health, School of Psychological Sciences, Monash University, Clayton, VIC 3800, Australia; Wellcome Centre for Human Neuroimaging, University College London, WC1N 3AR London, United Kingdom; CIFAR Azrieli Global Scholars Program, CIFAR, Toronto, ON, Canada.
| | - Matthew Su
- H. Ben Taub Department of Physical Medicine and Rehabilitation, Baylor College of Medicine, Houston, TX, USA.
| | - David F Tate
- TBI and Concussion Center, Department of Neurology, University of Utah, Salt Lake City, UT, USA; George E. Wahlen Veterans Affairs Medical Center, Salt Lake City, UT, USA.
| | - Carmen Velez
- TBI and Concussion Center, Department of Neurology, University of Utah, Salt Lake City, UT, USA; George E. Wahlen Veterans Affairs Medical Center, Salt Lake City, UT, USA.
| | - Elisabeth A Wilde
- H. Ben Taub Department of Physical Medicine and Rehabilitation, Baylor College of Medicine, Houston, TX, USA; TBI and Concussion Center, Department of Neurology, University of Utah, Salt Lake City, UT, USA; George E. Wahlen Veterans Affairs Medical Center, Salt Lake City, UT, USA.
| | - Brandon A Zielinski
- Departments of Pediatrics, Neurology, and Neuroscience, University of Florida, Gainesville, FL, USA; Departments of Pediatrics, Neurology, and Radiology, University of Utah, Salt Lake City, UT, USA.
| | - Paul M Thompson
- Imaging Genetics Center, Mark and Mary Stevens Neuroimaging & Informatics Institute, University of Southern California, Marina del Rey, CA, USA.
| | - Frank G Hillary
- Department of Psychology, Penn State University, State College, PA, USA; Department of Neurology, Hershey Medical Center, PA, USA.
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Grewal D, Baldini D, Liou-Johnson V, Adamson MM. B - 52 Effects of rTMS Treatment on Attention Measured by the CANTAB Rapid Visual Information Processing Module. Arch Clin Neuropsychol 2023; 38:1416. [PMID: 37807430 DOI: 10.1093/arclin/acad067.258] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/10/2023] Open
Abstract
OBJECTIVE Traumatic brain injury (TBI) has been associated with decreased performance in sustained attention tasks (Sinclair et al., 2013). Non-invasive neurostimulation techniques, such as repetitive transcranial magnetic stimulation (rTMS) may be utilized to improve cognitive outcomes, however there is uncertainty about which cognitive outcomes should be investigated (Clark & Parasuraman, 2014; Donaldson et al., 2015). The present study examines the observed enhancements in sustained attention related to rTMS administered to older adults with TBI. We utilized the Cambridge Neuropsychological Test Automated Battery (CANTAB), a commonly used assessment instrument in research settings that offers various modules for measuring neurocognitive functions (CDC). METHODS Veterans and civilians were enrolled (n = 28; mild and moderate TBI; mean age = 62.25) in either placebo or an active group. Participants received neuropsychological assessment at baseline, after 20 rTMS treatments, and at six month follow up. Participants were administered the CANTAB Rapid Visual Information Processing (RVIP) module to assess sustained attention after active rTMS or sham treatment. RESULTS Findings revealed that the active rTMS treatment group had a lower RVIPPFA (n = 12; M = 0.003; SD = 0.003) compared to the sham group (n = 16; M = 0.02; SD = 0.06), indicating a potential improvement in visual sustained attention. A moderate effect size was observed between the two groups (Cohen's d = 0.48). CONCLUSION The results suggest that rTMS treatment could potentially enhance cognitive performance, specifically visual sustained attention, in older adults. Further research is warranted to investigate the impact of rTMS on sustained attention and its clinical implications.
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Baldini D, Grewal D, Liou-Johnson V, Adamson MM. B - 56 Effects of rTMS Treatment on Executive Function Measured by the CANTAB Spatial Working Memory Subtest. Arch Clin Neuropsychol 2023; 38:1420. [PMID: 37807456 DOI: 10.1093/arclin/acad067.262] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/10/2023] Open
Abstract
OBJECTIVE Traumatic Brain Injury (TBI) presents with deficits in executive function (Krawczyk et al., 2019). Repetitive transcranial magnetic stimulation (rTMS), a non-invasive neuromodulation treatment, may help improve cognitive outcomes. However, it remains unclear in which cognitive domains (Clark & Parasuraman, 2014; Donaldson et al., 2015). This study investigates executive function using the Spatial Working Memory subtest of the Cambridge Neuropsychological Test Automated Battery, a computerized card-matching task in which participants match up to 12 cards to matched pairs based on memory (CDC). METHODS Veterans and civilians were enrolled (n = 31; mild and moderate TBI; mean age = 62.25) and placed into active or sham groups. Participants received neuropsychological assessment at baseline, after 20 rTMS treatments, and at six-month follow-up. This study compared means between the active and sham groups (n = 16 & 15, respectively). RESULTS Participants in the active group had fewer errors than the sham group on the 12-box trial (M = 24.19, SD = 11.20; M = 34.27, SD = 18.16; respectively), 8-box trial (M = 6.75, SD = 5.447; M = 8.27, SD = 6.11; respectively), 6-box trial (M = 2.06, SD = 3.00; M = 3.60, SD = 4.03; respectively) and across the 4, 6 and 8-box trials (M = 9.75, SD = 8.57; M = 12.47, SD = 10.04; respectively). Effect sizes were small to large (d = 0.28-0.67). CONCLUSION The results suggest that rTMS treatment potentially enhances executive functioning in older adults with TBI. Further research on the impacts of rTMS in executive function domains is warranted.
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Kazemi R, Rostami R, Nasiri Z, Hadipour AL, Kiaee N, Coetzee JP, Philips A, Brown R, Seenivasan S, Adamson MM. Electrophysiological and behavioral effects of unilateral and bilateral rTMS; A randomized clinical trial on rumination and depression. J Affect Disord 2022; 317:360-372. [PMID: 36055535 DOI: 10.1016/j.jad.2022.08.098] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/11/2022] [Revised: 08/24/2022] [Accepted: 08/26/2022] [Indexed: 11/28/2022]
Abstract
BACKGROUND Rumination is significantly frequent in major depressive disorder (MDD). However, not a lot of studies have investigated the effects of repetitive transcranial magnetic stimulation (rTMS) on rumination. METHODS 61 participants with a minimum Hamilton Depression Rating Scale (HAM-D) score of 20 were randomly assigned to sham, bilateral stimulation (BS) or unilateral stimulation (US) groups. EEG, The Ruminative Response Scale (RRS), and HAM-D were administered before and after the 20 sessions of rTMS. Phase locked values (PLV) were calculated as a measure of connectivity. RESULTS There was a significant decrease in HAM-D scores in both BS and US. In responders, BS and US differed significantly in RRS total scores, with greater reduction in BS. PLV significantly changed in the default mode network (DMN) in delta, theta, alpha, and beta in BS, in responders of which PLV decreased in the DMN in beta and gamma. Positive correlations between PLV and brooding in delta and theta, and negative correlations between PLV and reflection were found in theta, alpha, and beta. In US, connectivity in the DMN increased in beta, and PLV increased in theta and beta, and decreased in alpha and beta in its responders. Positive correlations between PLV and brooding in the delta and theta, as well as negative correlations between PLV and reflection in theta were observed in the DMN. CONCLUSION US and BS resulted in different modulations in the DMN, however, both could alleviate both rumination and depression. Reductions in the beta and alpha frequency bands in the DMN can be considered as potential EEG-based markers of response to bilateral and unilateral rTMS, respectively.
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Affiliation(s)
- Reza Kazemi
- Department of Cognitive Psychology, Institute for Cognitive Science Studies, Tehran, Iran.
| | - Reza Rostami
- Department of Psychology, University of Tehran, Tehran, Iran; Atieh Clinical Neuroscience Center, Tehran, Iran
| | - Zahra Nasiri
- Atieh Clinical Neuroscience Center, Tehran, Iran
| | - Abed L Hadipour
- Department of Cognitive Sciences, University of Messina, Messina, Italy
| | - Nasim Kiaee
- Atieh Clinical Neuroscience Center, Tehran, Iran
| | - John P Coetzee
- Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, Stanford, CA, USA; Rehabilitation Service, Veterans Affairs Palo Alto Health Care System, Palo Alto, CA, USA
| | - Angela Philips
- Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, Stanford, CA, USA; Rehabilitation Service, Veterans Affairs Palo Alto Health Care System, Palo Alto, CA, USA
| | - Randi Brown
- Department of Psychology, Palo Alto University, Palo Alto, CA, USA
| | - Srija Seenivasan
- Rehabilitation Service, Veterans Affairs Palo Alto Health Care System, Palo Alto, CA, USA
| | - Maheen M Adamson
- Rehabilitation Service, Veterans Affairs Palo Alto Health Care System, Palo Alto, CA, USA; Department of Neurosurgery, Stanford University School of Medicine, Stanford, CA, USA
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Bouchard HC, Sun D, Dennis EL, Newsome MR, Disner SG, Elman J, Silva A, Velez C, Irimia A, Davenport ND, Sponheim SR, Franz CE, Kremen WS, Coleman MJ, Williams MW, Geuze E, Koerte IK, Shenton ME, Adamson MM, Coimbra R, Grant G, Shutter L, George MS, Zafonte RD, McAllister TW, Stein MB, Thompson PM, Wilde EA, Tate DF, Sotiras A, Morey RA. Age-dependent white matter disruptions after military traumatic brain injury: Multivariate analysis results from ENIGMA brain injury. Hum Brain Mapp 2022; 43:2653-2667. [PMID: 35289463 PMCID: PMC9057089 DOI: 10.1002/hbm.25811] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2021] [Revised: 12/18/2021] [Accepted: 02/10/2022] [Indexed: 01/27/2023] Open
Abstract
Mild Traumatic brain injury (mTBI) is a signature wound in military personnel, and repetitive mTBI has been linked to age-related neurogenerative disorders that affect white matter (WM) in the brain. However, findings of injury to specific WM tracts have been variable and inconsistent. This may be due to the heterogeneity of mechanisms, etiology, and comorbid disorders related to mTBI. Non-negative matrix factorization (NMF) is a data-driven approach that detects covarying patterns (components) within high-dimensional data. We applied NMF to diffusion imaging data from military Veterans with and without a self-reported TBI history. NMF identified 12 independent components derived from fractional anisotropy (FA) in a large dataset (n = 1,475) gathered through the ENIGMA (Enhancing Neuroimaging Genetics through Meta-Analysis) Military Brain Injury working group. Regressions were used to examine TBI- and mTBI-related associations in NMF-derived components while adjusting for age, sex, post-traumatic stress disorder, depression, and data acquisition site/scanner. We found significantly stronger age-dependent effects of lower FA in Veterans with TBI than Veterans without in four components (q < 0.05), which are spatially unconstrained by traditionally defined WM tracts. One component, occupying the most peripheral location, exhibited significantly stronger age-dependent differences in Veterans with mTBI. We found NMF to be powerful and effective in detecting covarying patterns of FA associated with mTBI by applying standard parametric regression modeling. Our results highlight patterns of WM alteration that are differentially affected by TBI and mTBI in younger compared to older military Veterans.
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Affiliation(s)
- Heather C. Bouchard
- Duke‐UNC Brain Imaging and Analysis CenterDuke UniversityDurhamNorth CarolinaUSA
- Mid‐Atlantic Mental Illness Research Education and Clinical CenterDurham VA Medical CenterDurhamNorth CarolinaUSA
- Center for Brain, Biology & BehaviorUniversity of Nebraska‐LincolnLincolnNebraskaUSA
| | - Delin Sun
- Duke‐UNC Brain Imaging and Analysis CenterDuke UniversityDurhamNorth CarolinaUSA
- Mid‐Atlantic Mental Illness Research Education and Clinical CenterDurham VA Medical CenterDurhamNorth CarolinaUSA
| | - Emily L. Dennis
- Department of NeurologyUniversity of UtahSalt Lake CityUtahUSA
- Department of RadiologyStanford UniversityStanfordCaliforniaUSA
| | - Mary R. Newsome
- Michael E. DeBakey VA Medical CenterHoustonTexasUSA
- H. Ben Taub Department of Physical Medicine and RehabilitationBaylor College of MedicineHoustonTexasUSA
| | - Seth G. Disner
- Minneapolis VA Health Care SystemMinneapolisMinnesotaUSA
- Department of PsychiatryUniversity of Minnesota Medical SchoolMinneapolisMinnesotaUSA
| | - Jeremy Elman
- Department of PsychiatryUniversity of California San DiegoLa JollaCaliforniaUSA
- Center for Behavior Genetics of AgingUniversity of California, San DiegoSan DiegoCaliforniaUSA
| | - Annelise Silva
- Psychiatry Neuroimaging LaboratoryBrigham & Women's HospitalBostonMassachusettsUSA
| | - Carmen Velez
- Department of NeurologyUniversity of UtahSalt Lake CityUtahUSA
- George E. Wahlen Veterans Affairs Medical CenterSalt Lake CityUtahUSA
| | - Andrei Irimia
- Leonard Davis School of GerontologyUniversity of Southern CaliforniaLos AngelesCaliforniaUSA
- Department of Biomedical Engineering, Viterbi School of EngineeringUniversity of Southern CaliforniaLos AngelesCaliforniaUSA
| | - Nicholas D. Davenport
- Minneapolis VA Health Care SystemMinneapolisMinnesotaUSA
- Department of PsychiatryUniversity of Minnesota Medical SchoolMinneapolisMinnesotaUSA
| | - Scott R. Sponheim
- Minneapolis VA Health Care SystemMinneapolisMinnesotaUSA
- Department of PsychiatryUniversity of Minnesota Medical SchoolMinneapolisMinnesotaUSA
| | - Carol E. Franz
- Department of PsychiatryUniversity of California San DiegoLa JollaCaliforniaUSA
- Center for Behavior Genetics of AgingUniversity of California, San DiegoSan DiegoCaliforniaUSA
| | - William S. Kremen
- Department of PsychiatryUniversity of California San DiegoLa JollaCaliforniaUSA
- Center for Behavior Genetics of AgingUniversity of California, San DiegoSan DiegoCaliforniaUSA
- Center of Excellence for Stress and Mental HealthVA San Diego Healthcare SystemSan DiegoCaliforniaUSA
| | - Michael J. Coleman
- Psychiatry Neuroimaging LaboratoryBrigham & Women's HospitalBostonMassachusettsUSA
| | - M. Wright Williams
- Michael E. DeBakey VA Medical CenterHoustonTexasUSA
- Menninger Department of Psychiatry and Behavioral SciencesBaylor College of MedicineHoustonTexasUSA
| | - Elbert Geuze
- Department of PsychiatryUniversity Medical CenterUtrechtNetherlands
- Brain Research & Innovation CentreMinistry of DefenceUtrechtNetherlands
| | - Inga K. Koerte
- Psychiatry Neuroimaging LaboratoryBrigham & Women's HospitalBostonMassachusettsUSA
| | - Martha E. Shenton
- Psychiatry Neuroimaging LaboratoryBrigham & Women's HospitalBostonMassachusettsUSA
| | - Maheen M. Adamson
- Rehabilitation ServiceVA Palo AltoPalo AltoCaliforniaUSA
- NeurosurgeryStanford School of MedicineStanfordCaliforniaUSA
| | - Raul Coimbra
- Department of SurgeryUniversity of California San DiegoLa JollaCaliforniaUSA
| | - Gerald Grant
- Department of NeurosurgeryStanford University Medical CenterPalo AltoCaliforniaUSA
| | - Lori Shutter
- Department of Critical Care MedicineUniversity of Pittsburgh School of MedicinePittsburghPennsylvaniaUSA
| | - Mark S. George
- Department of PsychiatryMedical University of South CarolinaCharlestonSouth CarolinaUSA
| | - Ross D. Zafonte
- Spaulding Rehabilitation HospitalMassachusetts General Hospital, Brigham and Women's Hospital and Harvard Medical SchoolBostonMassachusettsUSA
| | | | - Murray B. Stein
- Department of PsychiatryUniversity of California San DiegoLa JollaCaliforniaUSA
- Herbert Wertheim School of Public Health and Human Longevity ScienceUniversity of California San DiegoLa JollaCaliforniaUSA
| | - Paul M. Thompson
- Imaging Genetics Center, Stevens Neuroimaging & Informatics InstituteKeck School of Medicine of USCMarina del ReyCaliforniaUSA
- Department of Neurology, Pediatrics, Psychiatry, Radiology, Engineering, and OphthalmologyUniversity of Southern California (USC), Los AngelesCaliforniaUSA
- Department of PediatricsUSCLos AngelesCaliforniaUSA
- Department of PsychiatryUSCLos AngelesCaliforniaUSA
- Department of RadiologyUSCLos AngelesCaliforniaUSA
- Department of EngineeringUSCLos AngelesCaliforniaUSA
- Department of OphthalmologyUSCLos AngelesCaliforniaUSA
- Department of Radiology and Institute for Informatics, School of MedicineWashington University St. LouisSt. LouisMissouriUSA
| | - Elisabeth A. Wilde
- Department of NeurologyUniversity of UtahSalt Lake CityUtahUSA
- Michael E. DeBakey VA Medical CenterHoustonTexasUSA
- George E. Wahlen Veterans Affairs Medical CenterSalt Lake CityUtahUSA
| | - David F. Tate
- Department of NeurologyUniversity of UtahSalt Lake CityUtahUSA
- George E. Wahlen Veterans Affairs Medical CenterSalt Lake CityUtahUSA
| | - Aristeidis Sotiras
- Department of Radiology and Institute for Informatics, School of MedicineWashington University St. LouisSt. LouisMissouriUSA
| | - Rajendra A. Morey
- Duke‐UNC Brain Imaging and Analysis CenterDuke UniversityDurhamNorth CarolinaUSA
- Mid‐Atlantic Mental Illness Research Education and Clinical CenterDurham VA Medical CenterDurhamNorth CarolinaUSA
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Luttenbacher I, Phillips A, Kazemi R, Hadipour AL, Sanghvi I, Martinez J, Adamson MM. Transdiagnostic role of glutamate and white matter damage in neuropsychiatric disorders: A Systematic Review. J Psychiatr Res 2022; 147:324-348. [PMID: 35151030 DOI: 10.1016/j.jpsychires.2021.12.042] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/21/2021] [Revised: 12/08/2021] [Accepted: 12/19/2021] [Indexed: 12/09/2022]
Abstract
Neuropsychiatric disorders including generalized anxiety disorder (GAD), obsessive-compulsive disorder (OCD), major depressive disorder (MDD), bipolar disorder (BD), and schizophrenia (SZ) have been considered distinct categories of diseases despite their overlapping characteristics and symptomatology. We aimed to provide an in-depth review elucidating the role of glutamate/Glx and white matter (WM) abnormalities in these disorders from a transdiagnostic perspective. The PubMed online database was searched for studies published between 2010 and 2021. After careful screening, 401 studies were included. The findings point to decreased levels of glutamate in the Anterior Cingulate Cortex in both SZ and BD, whereas Glx is elevated in the Hippocampus in SZ and MDD. With regard to WM abnormalities, the Corpus Callosum and superior Longitudinal Fascicle were the most consistently identified brain regions showing decreased fractional anisotropy (FA) across all the reviewed disorders, except GAD. Additionally, the Uncinate Fasciculus displayed decreased FA in all disorders, except OCD. Decreased FA was also found in the inferior Longitudinal Fasciculus, inferior Fronto-Occipital Fasciculus, Thalamic Radiation, and Corona Radiata in SZ, BD, and MDD. Decreased FA in the Fornix and Corticospinal Tract were found in BD and SZ patients. The Cingulum and Anterior Limb of Internal Capsule exhibited decreased FA in MDD and SZ patients. The results suggest a gradual increase in severity from GAD to SZ defined by the number of brain regions with WM abnormality which may be partially caused by abnormal glutamate levels. WM damage could thus be considered a potential marker of some of the main neuropsychiatric disorders.
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Affiliation(s)
- Ines Luttenbacher
- Department of Social & Behavioral Sciences, University of Amsterdam, Amsterdam, Netherlands; Rehabilitation Service, Veterans Affairs Palo Alto Health Care System, Palo Alto, CA, USA
| | - Angela Phillips
- Rehabilitation Service, Veterans Affairs Palo Alto Health Care System, Palo Alto, CA, USA; Department of Psychiatry & Behavioral Sciences, Stanford University School of Medicine, Stanford, CA, USA
| | - Reza Kazemi
- Department of Cognitive Psychology, Institute for Cognitive Science Studies, Tehran, Iran
| | - Abed L Hadipour
- Department of Cognitive Sciences, University of Messina, Messina, Italy
| | - Isha Sanghvi
- Rehabilitation Service, Veterans Affairs Palo Alto Health Care System, Palo Alto, CA, USA; Department of Neuroscience, University of Southern California, Los Angeles, CA, USA
| | - Julian Martinez
- Rehabilitation Service, Veterans Affairs Palo Alto Health Care System, Palo Alto, CA, USA; Palo Alto University, Palo Alto, CA, USA
| | - Maheen M Adamson
- Rehabilitation Service, Veterans Affairs Palo Alto Health Care System, Palo Alto, CA, USA; Department of Neurosurgery, Stanford University School of Medicine, Stanford, CA, USA.
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Adamson MM, Main K, Harris OA, Kang X. Sex differences in cortical thickness and diffusion properties in patients with traumatic brain injury: a pilot study. Brain Inj 2022; 36:488-502. [PMID: 35113752 DOI: 10.1080/02699052.2022.2034046] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/02/2022]
Abstract
OBJECTIVE Cortical thickness and diffusion properties are important measures of gray and white matter integrity in those with traumatic brain injury (TBI). Many studies show that healthy adult females have greater cortical thickness than males across numerous brain sites. In this study, we explored this sex difference in patients with TBI. METHOD Participants consisted of 32 patients with TBI and 21 neurologically healthy controls. All were scanned by magnetic resonance imaging (MRI). Differences in cortical thickness and diffusion properties were examined between groups (i.e., TBI/control, male/female). RESULTS Patients with TBI had more cortical thinning (both hemispheres) compared to controls. They also showed decreased fractional anisotropy (FA) for several major white matter tracts. Healthy females had significantly greater cortical thickness compared to healthy males. However, this difference was smaller among the patients with TBI. We found no sex differences in diffusion properties. There were moderate correlations between cortical thickness, diffusion properties, and cognitive performance, as measured by the Trail Making Test B. CONCLUSION These findings contribute to a growing discussion on sex differences in cortical thickness and diffusion properties. Sexual dimorphism could necessitate different clinical profiles, targets, and rehabilitation strategies in patients with TBI.
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Affiliation(s)
- Maheen M Adamson
- Rehabilitation Service, VA Palo Alto Health Care System, Palo Alto, California, USA.,Department of Neurosurgery, Stanford University School of Medicine, Palo Alto, California, USA
| | - Keith Main
- Research Division, Traumatic Brain Injury Center of Excellence, Silver Spring, Maryland, USA.,General Dynamics Information Technology, Falls Church, Virginia, USA
| | - Odette A Harris
- Rehabilitation Service, VA Palo Alto Health Care System, Palo Alto, California, USA.,Department of Neurosurgery, Stanford University School of Medicine, Palo Alto, California, USA
| | - Xiaojian Kang
- Rehabilitation Service, VA Palo Alto Health Care System, Palo Alto, California, USA
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8
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Uyulan C, de la Salle S, Erguzel TT, Lynn E, Blier P, Knott V, Adamson MM, Zelka M, Tarhan N. Depression Diagnosis Modeling With Advanced Computational Methods: Frequency-Domain eMVAR and Deep Learning. Clin EEG Neurosci 2022; 53:24-36. [PMID: 34080925 DOI: 10.1177/15500594211018545] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Electroencephalogram (EEG)-based automated depression diagnosis systems have been suggested for early and accurate detection of mood disorders. EEG signals are highly irregular, nonlinear, and nonstationary in nature and are traditionally studied from a linear viewpoint by means of statistical and frequency features. Since, linear metrics present certain limitations and nonlinear methods have proven to be an efficient tool in understanding the complexities of the brain in the identification of underlying behavior of biological signals, such as electrocardiogram, EEG and magnetoencephalogram and thus, can be applied to all nonstationary signals. Various nonlinear algorithms can be used in the analysis of EEG signals. In this research paper, we aim to develop a novel methodology for EEG-based depression diagnosis utilizing 2 advanced computational techniques: frequency-domain extended multivariate autoregressive (eMVAR) and deep learning (DL). We proposed a hybrid method comprising a pretrained ResNet-50 and long-short term memory (LSTM) to capture depression-specific information and compared with a strong conventional machine learning (ML) framework having eMVAR connectivity features. The following 8 causality measures, which interpret the interaction mechanisms among spectrally decomposed oscillations, were used to extract features from multivariate EEG time series: directed coherence (DC), directed transfer function (DTF), partial DC (PDC), generalized PDC (gPDC), extended DC (eDC), delayed DC (dDC), extended PDC (ePDC), and delayed PDC (dPDC). The classification accuracies were 84% with DC, 85% with DTF, 95.3% with PDC, 95.1% with gPDC, 84.8% with eDC, 84.6% with dDC, 84.2% with ePDC, and 95.9% with dPDC for the eMVAR framework. Through a DL framework (ResNet-50 + LSTM), the classification accuracy was achieved as 90.22%. The results demonstrate that our DL methodology is a competitive alternative to the strong feature extraction-based ML methods in depression classification.
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Affiliation(s)
| | - Sara de la Salle
- Institute of Mental Health Research, 6363University of Ottawa, Ottawa, ON, Canada.,6363University of Ottawa, Ottawa, ON, Canada
| | | | - Emma Lynn
- Institute of Mental Health Research, 6363University of Ottawa, Ottawa, ON, Canada.,6363University of Ottawa, Ottawa, ON, Canada
| | - Pierre Blier
- Institute of Mental Health Research, 6363University of Ottawa, Ottawa, ON, Canada.,6363University of Ottawa, Ottawa, ON, Canada
| | - Verner Knott
- Institute of Mental Health Research, 6363University of Ottawa, Ottawa, ON, Canada.,6363University of Ottawa, Ottawa, ON, Canada
| | | | | | - Nevzat Tarhan
- 232990Uskudar University, Istanbul, Turkey.,NPIstanbul Hospital, Istanbul, Turkey
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9
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Kazemi R, Rostami R, Nasiri Z, Hadipour AL, Kiaee N, Coetzee JP, Phillips A, Zhu K, Adamson MM. Electrophysiological and behavioral effects of bilateral and unilateral rTMS on rumination and depression. Brain Stimul 2021. [DOI: 10.1016/j.brs.2021.10.058] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022] Open
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10
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Tate DF, Dennis EL, Adams JT, Adamson MM, Belanger HG, Bigler ED, Bouchard HC, Clark AL, Delano-Wood LM, Disner SG, Eapen BC, Franz CE, Geuze E, Goodrich-Hunsaker NJ, Han K, Hayes JP, Hinds SR, Hodges CB, Hovenden ES, Irimia A, Kenney K, Koerte IK, Kremen WS, Levin HS, Lindsey HM, Morey RA, Newsome MR, Ollinger J, Pugh MJ, Scheibel RS, Shenton ME, Sullivan DR, Taylor BA, Troyanskaya M, Velez C, Wade BS, Wang X, Ware AL, Zafonte R, Thompson PM, Wilde EA. Coordinating Global Multi-Site Studies of Military-Relevant Traumatic Brain Injury: Opportunities, Challenges, and Harmonization Guidelines. Brain Imaging Behav 2021; 15:585-613. [PMID: 33409819 PMCID: PMC8035292 DOI: 10.1007/s11682-020-00423-2] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/24/2020] [Indexed: 12/19/2022]
Abstract
Traumatic brain injury (TBI) is common among military personnel and the civilian population and is often followed by a heterogeneous array of clinical, cognitive, behavioral, mood, and neuroimaging changes. Unlike many neurological disorders that have a characteristic abnormal central neurologic area(s) of abnormality pathognomonic to the disorder, a sufficient head impact may cause focal, multifocal, diffuse or combination of injury to the brain. This inconsistent presentation makes it difficult to establish or validate biological and imaging markers that could help improve diagnostic and prognostic accuracy in this patient population. The purpose of this manuscript is to describe both the challenges and opportunities when conducting military-relevant TBI research and introduce the Enhancing NeuroImaging Genetics through Meta-Analysis (ENIGMA) Military Brain Injury working group. ENIGMA is a worldwide consortium focused on improving replicability and analytical power through data sharing and collaboration. In this paper, we discuss challenges affecting efforts to aggregate data in this patient group. In addition, we highlight how "big data" approaches might be used to understand better the role that each of these variables might play in the imaging and functional phenotypes of TBI in Service member and Veteran populations, and how data may be used to examine important military specific issues such as return to duty, the late effects of combat-related injury, and alteration of the natural aging processes.
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Affiliation(s)
- David F Tate
- Department of Neurology, University of Utah School of Medicine, Salt Lake City, UT, USA.
- George E. Wahlen Veterans Affairs Medical Center, Salt Lake City, UT, USA.
| | - Emily L Dennis
- Department of Neurology, University of Utah School of Medicine, Salt Lake City, UT, USA
- George E. Wahlen Veterans Affairs Medical Center, Salt Lake City, UT, USA
- Imaging Genetics Center, Stevens Neuroimaging & Informatics Institute, Keck School of Medicine of USC, Marina del Rey, Los Angeles, CA, USA
| | - John T Adams
- Western University of Health Sciences, Pomona, CA, USA
| | - Maheen M Adamson
- Defense and Veterans Brain Injury Center, VA Palo Alto, Palo Alto, CA, USA
- Neurosurgery, Stanford School of Medicine, Stanford, CA, USA
| | - Heather G Belanger
- United States Special Operations Command (USSOCOM), Tampa, FL, USA
- Department of Psychology, University of South Florida, Tampa, FL, USA
- Department of Psychiatry and Behavioral Neurosciences, University of South Florida, Tampa, FL, USA
- St Michaels Inc, Tampa, FL, USA
| | - Erin D Bigler
- Department of Neurology, University of Utah School of Medicine, Salt Lake City, UT, USA
- Department of Psychology, Brigham Young University, Provo, UT, USA
- Neuroscience Center, Brigham Young University, Provo, UT, USA
| | - Heather C Bouchard
- Duke-UNC Brain Imaging and Analysis Center, Duke University, Durham, NC, USA
| | - Alexandra L Clark
- VA San Diego Healthcare System, San Diego, CA, USA
- Department of Psychiatry, University of California, San Diego, La Jolla, CA, USA
| | - Lisa M Delano-Wood
- VA San Diego Healthcare System, San Diego, CA, USA
- Department of Psychiatry, University of California, San Diego, La Jolla, CA, USA
- Center of Excellence for Stress and Mental Health, VA San Diego Healthcare System, La Jolla, CA, USA
| | - Seth G Disner
- Department of Psychiatry, University of Minnesota Medical School, Minneapolis, MN, USA
- Minneapolis VA Health Care System, Minneapolis, MN, USA
| | - Blessen C Eapen
- Department of Physical Medicine and Rehabilitation, VA Greater Los Angeles Health Care System, Los Angeles, CA, USA
- Department of Medicine, David Geffen School of Medicine at UCLA, Los Angeles, CA, USA
| | - Carol E Franz
- Department of Psychiatry, University of California, San Diego, La Jolla, CA, USA
- Center for Behavior Genetics of Aging, University of California, San Diego, La Jolla, CA, USA
| | - Elbert Geuze
- University Medical Center Utrecht, Utrecht, Netherlands
- Brain Research and Innovation Centre, Ministry of Defence, Utrecht, The Netherlands
| | - Naomi J Goodrich-Hunsaker
- Department of Neurology, University of Utah School of Medicine, Salt Lake City, UT, USA
- George E. Wahlen Veterans Affairs Medical Center, Salt Lake City, UT, USA
- Department of Psychology, Brigham Young University, Provo, UT, USA
| | - Kihwan Han
- School of Behavioral and Brain Sciences, University of Texas at Dallas, Dallas, TX, USA
| | - Jasmeet P Hayes
- Psychology Department, The Ohio State University, Columbus, OH, USA
- Chronic Brain Injury Program, The Ohio State University, Columbus, OH, USA
| | - Sidney R Hinds
- Department of Defense/United States Army Medical Research and Materiel Command, Fort Detrick, Frederick, MD, USA
- Department of Neurology, Uniformed Services University of the Health Sciences, Bethesda, MD, USA
| | - Cooper B Hodges
- Department of Neurology, University of Utah School of Medicine, Salt Lake City, UT, USA
- George E. Wahlen Veterans Affairs Medical Center, Salt Lake City, UT, USA
- Department of Psychology, Brigham Young University, Provo, UT, USA
| | - Elizabeth S Hovenden
- Department of Neurology, University of Utah School of Medicine, Salt Lake City, UT, USA
| | - Andrei Irimia
- Leonard Davis School of Gerontology, University of Southern California, Los Angeles, CA, USA
- Department of Biomedical Engineering, Viterbi School of Engineering, University of Southern California, Los Angeles, CA, USA
| | - Kimbra Kenney
- Department of Neurology, Uniformed Services University of the Health Sciences, Bethesda, MD, USA
- National Intrepid Center of Excellence, Walter Reed National Military Medical Center, Bethesda, MD, USA
| | - Inga K Koerte
- Psychiatry Neuroimaging Laboratory, Brigham and Women's Hospital, Boston, MA, USA
- Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, Ludwig-Maximilians-Universität, Munich, Germany
| | - William S Kremen
- Department of Psychiatry, University of California, San Diego, La Jolla, CA, USA
- Center of Excellence for Stress and Mental Health, VA San Diego Healthcare System, La Jolla, CA, USA
- Center for Behavior Genetics of Aging, University of California, San Diego, La Jolla, CA, USA
| | - Harvey S Levin
- H. Ben Taub Department of Physical Medicine and Rehabilitation, Baylor College of Medicine, Houston, TX, USA
- Michael E. DeBakey Veterans Affairs Medical Center, Houston, TX, USA
| | - Hannah M Lindsey
- Department of Neurology, University of Utah School of Medicine, Salt Lake City, UT, USA
- George E. Wahlen Veterans Affairs Medical Center, Salt Lake City, UT, USA
- Department of Psychology, Brigham Young University, Provo, UT, USA
| | - Rajendra A Morey
- Duke-UNC Brain Imaging and Analysis Center, Duke University, Durham, NC, USA
- Department of Psychiatry and Behavioral Sciences, Duke University, Durham, NC, USA
| | - Mary R Newsome
- H. Ben Taub Department of Physical Medicine and Rehabilitation, Baylor College of Medicine, Houston, TX, USA
- Michael E. DeBakey Veterans Affairs Medical Center, Houston, TX, USA
| | - John Ollinger
- National Intrepid Center of Excellence, Walter Reed National Military Medical Center, Bethesda, MD, USA
| | - Mary Jo Pugh
- Information Decision-Enhancement and Analytic Sciences Center, VA Salt Lake City, Salt Lake City, UT, USA
- Department of Medicine, University of Utah School of Medicine, Salt Lake City, UT, USA
| | - Randall S Scheibel
- H. Ben Taub Department of Physical Medicine and Rehabilitation, Baylor College of Medicine, Houston, TX, USA
- Michael E. DeBakey Veterans Affairs Medical Center, Houston, TX, USA
| | - Martha E Shenton
- Psychiatry Neuroimaging Laboratory, Brigham and Women's Hospital, Boston, MA, USA
- Brockton Division, VA Boston Healthcare System, Brockton, MA, USA
| | - Danielle R Sullivan
- National Center for PTSD, VA Boston Healthcare System, Boston, MA, USA
- Department of Psychiatry, Boston University School of Medicine, Boston, MA, USA
| | - Brian A Taylor
- Department of Biomedical Engineering, Virginia Commonwealth University, Richmond, VA, USA
- C. Kenneth and Dianne Wright Center for Clinical and Translational Research, Virginia Commonwealth University, Richmond, VA, USA
| | - Maya Troyanskaya
- H. Ben Taub Department of Physical Medicine and Rehabilitation, Baylor College of Medicine, Houston, TX, USA
- Michael E. DeBakey Veterans Affairs Medical Center, Houston, TX, USA
| | - Carmen Velez
- Department of Neurology, University of Utah School of Medicine, Salt Lake City, UT, USA
- George E. Wahlen Veterans Affairs Medical Center, Salt Lake City, UT, USA
| | - Benjamin Sc Wade
- Department of Neurology, University of Utah School of Medicine, Salt Lake City, UT, USA
- Ahmanson-Lovelace Brain Mapping Center, Department of Neurology, University of California, Los Angeles, Los Angeles, CA, USA
| | - Xin Wang
- Department of Psychiatry, University of Toledo, Toledo, OH, USA
| | - Ashley L Ware
- Department of Psychology, University of Calgary, Calgary, Alberta, Canada
| | - Ross Zafonte
- Department of Physical Medicine and Rehabilitation, Massachusetts General Hospital/Brigham & Women's Hospital, Boston, MA, USA
- Spaulding Rehabilitation Hospital, Harvard Medical School, Boston, MA, USA
| | - Paul M Thompson
- Imaging Genetics Center, Stevens Neuroimaging & Informatics Institute, Keck School of Medicine of USC, Marina del Rey, Los Angeles, CA, USA
- Department of Neurology, USC, Los Angeles, CA, USA
- Department of Pediatrics, USC, Los Angeles, CA, USA
- Department of Psychiatry, USC, Los Angeles, CA, USA
- Department of Radiology, USC, Los Angeles, CA, USA
- Department of Engineering, USC, Los Angeles, CA, USA
- Department of Ophthalmology, USC, Los Angeles, CA, USA
| | - Elisabeth A Wilde
- Department of Neurology, University of Utah School of Medicine, Salt Lake City, UT, USA
- George E. Wahlen Veterans Affairs Medical Center, Salt Lake City, UT, USA
- H. Ben Taub Department of Physical Medicine and Rehabilitation, Baylor College of Medicine, Houston, TX, USA
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11
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Hantke N, Adamson MM, Noda A, Lazzeroni LC, Beaudreau SA, Yutsis M, Fairchild JK, Kinoshita LM, Kong J, Sheng T, Waltzman D, Ashford JW, Yesavage JA. Posttraumatic Stress Disorder-Associated Cognitive Deficits on the Repeatable Battery for the Assessment of Neuropsychological Status in a Veteran Population. Fed Pract 2021; 38:28-34. [PMID: 33574646 DOI: 10.12788/fp.0083] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Background Posttraumatic stress disorder (PTSD) is a frequent problem of veterans receiving care and is often associated with cognitive deficits. The Repeatable Battery for the Assessment of Neuropsychological Status (RBANS) is a well-validated cognitive screening measure often used in the US Department of Veterans Affairs (VA), particularly in neurorehabilitation settings. However, the influence of PTSD on RBANS performance is unclear, particularly within a heterogeneous VA outpatient population in which PTSD and traumatic brain injury (TBI) may not be the primary focus of care. Methods Participants included 153 veterans with complex deployment-related health problems, including a diagnosis of PTSD (n = 98) and a history of TBI (n = 92). All veterans completed a targeted cognitive battery that included the Wechsler Test of Adult Reading, the Wechsler Adults Intelligence Scale, measure assessing processing speed, attention, and cognitive flexibility, and RBANS. Results A diagnosis of PTSD was associated with worse performance on the Story Recall subtest of the RBANS, but not on any other cognitive measures. A diagnosis of mild TBI, or co-occurring PTSD and TBI did not predict cognitive performance on any measures. Conclusions The RBANS best captured cognitive deficits associated with PTSD compared with a history of mild TBI or co-occurring mild TBI and PTSD. These findings may provide insight into the interpretation and attribution of cognitive deficits in the veteran population.
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Affiliation(s)
- Nathan Hantke
- is a Clinical Neuropsychologist in the Mental Health and Clinical Neuroscience Division at the US Department of Veterans Affairs (VA) Portland Health Care System in Oregon. is a Postdoctoral Fellow, is a Clinical Director, is the Director, and is the Executive Director; all at the War Related Illness and Injury Study Center; is a Clinical Neuropsychologist at the VA Memory Clinic; is a Program Analyst in Polytrauma System of Care; is an Investigator in the Sierra Pacific Mental Illness Research, Education, and Clinical Center (MIRECC): is an Associate Director, is the Director; all at the MIRECC; is a Clincial Research Senior Scientific Director in the Rehabilitation Service, all at the VA Palo Alto Health Care System in California. is a Research Data Analyst, J. Kaci Fairchild, Sherry Beaudreau, John Ashford, Jerome Yesavage, and are Professors, Dana Waltzman is a Postdoctoral Fellow, all in the Stanford Department of Psychiatry and Behavioral Sciences; is a Clinical Neuropsychologist and Clinical Assistant Professor (affiliated) in the Stanford Neuroscience Institute, and Maheen Adamson is a Clinical Associate Professor in the Department of Neurosurgery, all at Stanford University School of Medicine in California. Nathan Hantke is an Assistant Professor in the Department of Neurology at Oregon Health and Science University in Portland
| | - Maheen M Adamson
- is a Clinical Neuropsychologist in the Mental Health and Clinical Neuroscience Division at the US Department of Veterans Affairs (VA) Portland Health Care System in Oregon. is a Postdoctoral Fellow, is a Clinical Director, is the Director, and is the Executive Director; all at the War Related Illness and Injury Study Center; is a Clinical Neuropsychologist at the VA Memory Clinic; is a Program Analyst in Polytrauma System of Care; is an Investigator in the Sierra Pacific Mental Illness Research, Education, and Clinical Center (MIRECC): is an Associate Director, is the Director; all at the MIRECC; is a Clincial Research Senior Scientific Director in the Rehabilitation Service, all at the VA Palo Alto Health Care System in California. is a Research Data Analyst, J. Kaci Fairchild, Sherry Beaudreau, John Ashford, Jerome Yesavage, and are Professors, Dana Waltzman is a Postdoctoral Fellow, all in the Stanford Department of Psychiatry and Behavioral Sciences; is a Clinical Neuropsychologist and Clinical Assistant Professor (affiliated) in the Stanford Neuroscience Institute, and Maheen Adamson is a Clinical Associate Professor in the Department of Neurosurgery, all at Stanford University School of Medicine in California. Nathan Hantke is an Assistant Professor in the Department of Neurology at Oregon Health and Science University in Portland
| | - Art Noda
- is a Clinical Neuropsychologist in the Mental Health and Clinical Neuroscience Division at the US Department of Veterans Affairs (VA) Portland Health Care System in Oregon. is a Postdoctoral Fellow, is a Clinical Director, is the Director, and is the Executive Director; all at the War Related Illness and Injury Study Center; is a Clinical Neuropsychologist at the VA Memory Clinic; is a Program Analyst in Polytrauma System of Care; is an Investigator in the Sierra Pacific Mental Illness Research, Education, and Clinical Center (MIRECC): is an Associate Director, is the Director; all at the MIRECC; is a Clincial Research Senior Scientific Director in the Rehabilitation Service, all at the VA Palo Alto Health Care System in California. is a Research Data Analyst, J. Kaci Fairchild, Sherry Beaudreau, John Ashford, Jerome Yesavage, and are Professors, Dana Waltzman is a Postdoctoral Fellow, all in the Stanford Department of Psychiatry and Behavioral Sciences; is a Clinical Neuropsychologist and Clinical Assistant Professor (affiliated) in the Stanford Neuroscience Institute, and Maheen Adamson is a Clinical Associate Professor in the Department of Neurosurgery, all at Stanford University School of Medicine in California. Nathan Hantke is an Assistant Professor in the Department of Neurology at Oregon Health and Science University in Portland
| | - Laura C Lazzeroni
- is a Clinical Neuropsychologist in the Mental Health and Clinical Neuroscience Division at the US Department of Veterans Affairs (VA) Portland Health Care System in Oregon. is a Postdoctoral Fellow, is a Clinical Director, is the Director, and is the Executive Director; all at the War Related Illness and Injury Study Center; is a Clinical Neuropsychologist at the VA Memory Clinic; is a Program Analyst in Polytrauma System of Care; is an Investigator in the Sierra Pacific Mental Illness Research, Education, and Clinical Center (MIRECC): is an Associate Director, is the Director; all at the MIRECC; is a Clincial Research Senior Scientific Director in the Rehabilitation Service, all at the VA Palo Alto Health Care System in California. is a Research Data Analyst, J. Kaci Fairchild, Sherry Beaudreau, John Ashford, Jerome Yesavage, and are Professors, Dana Waltzman is a Postdoctoral Fellow, all in the Stanford Department of Psychiatry and Behavioral Sciences; is a Clinical Neuropsychologist and Clinical Assistant Professor (affiliated) in the Stanford Neuroscience Institute, and Maheen Adamson is a Clinical Associate Professor in the Department of Neurosurgery, all at Stanford University School of Medicine in California. Nathan Hantke is an Assistant Professor in the Department of Neurology at Oregon Health and Science University in Portland
| | - Sherry A Beaudreau
- is a Clinical Neuropsychologist in the Mental Health and Clinical Neuroscience Division at the US Department of Veterans Affairs (VA) Portland Health Care System in Oregon. is a Postdoctoral Fellow, is a Clinical Director, is the Director, and is the Executive Director; all at the War Related Illness and Injury Study Center; is a Clinical Neuropsychologist at the VA Memory Clinic; is a Program Analyst in Polytrauma System of Care; is an Investigator in the Sierra Pacific Mental Illness Research, Education, and Clinical Center (MIRECC): is an Associate Director, is the Director; all at the MIRECC; is a Clincial Research Senior Scientific Director in the Rehabilitation Service, all at the VA Palo Alto Health Care System in California. is a Research Data Analyst, J. Kaci Fairchild, Sherry Beaudreau, John Ashford, Jerome Yesavage, and are Professors, Dana Waltzman is a Postdoctoral Fellow, all in the Stanford Department of Psychiatry and Behavioral Sciences; is a Clinical Neuropsychologist and Clinical Assistant Professor (affiliated) in the Stanford Neuroscience Institute, and Maheen Adamson is a Clinical Associate Professor in the Department of Neurosurgery, all at Stanford University School of Medicine in California. Nathan Hantke is an Assistant Professor in the Department of Neurology at Oregon Health and Science University in Portland
| | - Maya Yutsis
- is a Clinical Neuropsychologist in the Mental Health and Clinical Neuroscience Division at the US Department of Veterans Affairs (VA) Portland Health Care System in Oregon. is a Postdoctoral Fellow, is a Clinical Director, is the Director, and is the Executive Director; all at the War Related Illness and Injury Study Center; is a Clinical Neuropsychologist at the VA Memory Clinic; is a Program Analyst in Polytrauma System of Care; is an Investigator in the Sierra Pacific Mental Illness Research, Education, and Clinical Center (MIRECC): is an Associate Director, is the Director; all at the MIRECC; is a Clincial Research Senior Scientific Director in the Rehabilitation Service, all at the VA Palo Alto Health Care System in California. is a Research Data Analyst, J. Kaci Fairchild, Sherry Beaudreau, John Ashford, Jerome Yesavage, and are Professors, Dana Waltzman is a Postdoctoral Fellow, all in the Stanford Department of Psychiatry and Behavioral Sciences; is a Clinical Neuropsychologist and Clinical Assistant Professor (affiliated) in the Stanford Neuroscience Institute, and Maheen Adamson is a Clinical Associate Professor in the Department of Neurosurgery, all at Stanford University School of Medicine in California. Nathan Hantke is an Assistant Professor in the Department of Neurology at Oregon Health and Science University in Portland
| | - J Kaci Fairchild
- is a Clinical Neuropsychologist in the Mental Health and Clinical Neuroscience Division at the US Department of Veterans Affairs (VA) Portland Health Care System in Oregon. is a Postdoctoral Fellow, is a Clinical Director, is the Director, and is the Executive Director; all at the War Related Illness and Injury Study Center; is a Clinical Neuropsychologist at the VA Memory Clinic; is a Program Analyst in Polytrauma System of Care; is an Investigator in the Sierra Pacific Mental Illness Research, Education, and Clinical Center (MIRECC): is an Associate Director, is the Director; all at the MIRECC; is a Clincial Research Senior Scientific Director in the Rehabilitation Service, all at the VA Palo Alto Health Care System in California. is a Research Data Analyst, J. Kaci Fairchild, Sherry Beaudreau, John Ashford, Jerome Yesavage, and are Professors, Dana Waltzman is a Postdoctoral Fellow, all in the Stanford Department of Psychiatry and Behavioral Sciences; is a Clinical Neuropsychologist and Clinical Assistant Professor (affiliated) in the Stanford Neuroscience Institute, and Maheen Adamson is a Clinical Associate Professor in the Department of Neurosurgery, all at Stanford University School of Medicine in California. Nathan Hantke is an Assistant Professor in the Department of Neurology at Oregon Health and Science University in Portland
| | - Lisa M Kinoshita
- is a Clinical Neuropsychologist in the Mental Health and Clinical Neuroscience Division at the US Department of Veterans Affairs (VA) Portland Health Care System in Oregon. is a Postdoctoral Fellow, is a Clinical Director, is the Director, and is the Executive Director; all at the War Related Illness and Injury Study Center; is a Clinical Neuropsychologist at the VA Memory Clinic; is a Program Analyst in Polytrauma System of Care; is an Investigator in the Sierra Pacific Mental Illness Research, Education, and Clinical Center (MIRECC): is an Associate Director, is the Director; all at the MIRECC; is a Clincial Research Senior Scientific Director in the Rehabilitation Service, all at the VA Palo Alto Health Care System in California. is a Research Data Analyst, J. Kaci Fairchild, Sherry Beaudreau, John Ashford, Jerome Yesavage, and are Professors, Dana Waltzman is a Postdoctoral Fellow, all in the Stanford Department of Psychiatry and Behavioral Sciences; is a Clinical Neuropsychologist and Clinical Assistant Professor (affiliated) in the Stanford Neuroscience Institute, and Maheen Adamson is a Clinical Associate Professor in the Department of Neurosurgery, all at Stanford University School of Medicine in California. Nathan Hantke is an Assistant Professor in the Department of Neurology at Oregon Health and Science University in Portland
| | - Jennifer Kong
- is a Clinical Neuropsychologist in the Mental Health and Clinical Neuroscience Division at the US Department of Veterans Affairs (VA) Portland Health Care System in Oregon. is a Postdoctoral Fellow, is a Clinical Director, is the Director, and is the Executive Director; all at the War Related Illness and Injury Study Center; is a Clinical Neuropsychologist at the VA Memory Clinic; is a Program Analyst in Polytrauma System of Care; is an Investigator in the Sierra Pacific Mental Illness Research, Education, and Clinical Center (MIRECC): is an Associate Director, is the Director; all at the MIRECC; is a Clincial Research Senior Scientific Director in the Rehabilitation Service, all at the VA Palo Alto Health Care System in California. is a Research Data Analyst, J. Kaci Fairchild, Sherry Beaudreau, John Ashford, Jerome Yesavage, and are Professors, Dana Waltzman is a Postdoctoral Fellow, all in the Stanford Department of Psychiatry and Behavioral Sciences; is a Clinical Neuropsychologist and Clinical Assistant Professor (affiliated) in the Stanford Neuroscience Institute, and Maheen Adamson is a Clinical Associate Professor in the Department of Neurosurgery, all at Stanford University School of Medicine in California. Nathan Hantke is an Assistant Professor in the Department of Neurology at Oregon Health and Science University in Portland
| | - Tong Sheng
- is a Clinical Neuropsychologist in the Mental Health and Clinical Neuroscience Division at the US Department of Veterans Affairs (VA) Portland Health Care System in Oregon. is a Postdoctoral Fellow, is a Clinical Director, is the Director, and is the Executive Director; all at the War Related Illness and Injury Study Center; is a Clinical Neuropsychologist at the VA Memory Clinic; is a Program Analyst in Polytrauma System of Care; is an Investigator in the Sierra Pacific Mental Illness Research, Education, and Clinical Center (MIRECC): is an Associate Director, is the Director; all at the MIRECC; is a Clincial Research Senior Scientific Director in the Rehabilitation Service, all at the VA Palo Alto Health Care System in California. is a Research Data Analyst, J. Kaci Fairchild, Sherry Beaudreau, John Ashford, Jerome Yesavage, and are Professors, Dana Waltzman is a Postdoctoral Fellow, all in the Stanford Department of Psychiatry and Behavioral Sciences; is a Clinical Neuropsychologist and Clinical Assistant Professor (affiliated) in the Stanford Neuroscience Institute, and Maheen Adamson is a Clinical Associate Professor in the Department of Neurosurgery, all at Stanford University School of Medicine in California. Nathan Hantke is an Assistant Professor in the Department of Neurology at Oregon Health and Science University in Portland
| | - Dana Waltzman
- is a Clinical Neuropsychologist in the Mental Health and Clinical Neuroscience Division at the US Department of Veterans Affairs (VA) Portland Health Care System in Oregon. is a Postdoctoral Fellow, is a Clinical Director, is the Director, and is the Executive Director; all at the War Related Illness and Injury Study Center; is a Clinical Neuropsychologist at the VA Memory Clinic; is a Program Analyst in Polytrauma System of Care; is an Investigator in the Sierra Pacific Mental Illness Research, Education, and Clinical Center (MIRECC): is an Associate Director, is the Director; all at the MIRECC; is a Clincial Research Senior Scientific Director in the Rehabilitation Service, all at the VA Palo Alto Health Care System in California. is a Research Data Analyst, J. Kaci Fairchild, Sherry Beaudreau, John Ashford, Jerome Yesavage, and are Professors, Dana Waltzman is a Postdoctoral Fellow, all in the Stanford Department of Psychiatry and Behavioral Sciences; is a Clinical Neuropsychologist and Clinical Assistant Professor (affiliated) in the Stanford Neuroscience Institute, and Maheen Adamson is a Clinical Associate Professor in the Department of Neurosurgery, all at Stanford University School of Medicine in California. Nathan Hantke is an Assistant Professor in the Department of Neurology at Oregon Health and Science University in Portland
| | - John Wesson Ashford
- is a Clinical Neuropsychologist in the Mental Health and Clinical Neuroscience Division at the US Department of Veterans Affairs (VA) Portland Health Care System in Oregon. is a Postdoctoral Fellow, is a Clinical Director, is the Director, and is the Executive Director; all at the War Related Illness and Injury Study Center; is a Clinical Neuropsychologist at the VA Memory Clinic; is a Program Analyst in Polytrauma System of Care; is an Investigator in the Sierra Pacific Mental Illness Research, Education, and Clinical Center (MIRECC): is an Associate Director, is the Director; all at the MIRECC; is a Clincial Research Senior Scientific Director in the Rehabilitation Service, all at the VA Palo Alto Health Care System in California. is a Research Data Analyst, J. Kaci Fairchild, Sherry Beaudreau, John Ashford, Jerome Yesavage, and are Professors, Dana Waltzman is a Postdoctoral Fellow, all in the Stanford Department of Psychiatry and Behavioral Sciences; is a Clinical Neuropsychologist and Clinical Assistant Professor (affiliated) in the Stanford Neuroscience Institute, and Maheen Adamson is a Clinical Associate Professor in the Department of Neurosurgery, all at Stanford University School of Medicine in California. Nathan Hantke is an Assistant Professor in the Department of Neurology at Oregon Health and Science University in Portland
| | - Jerome A Yesavage
- is a Clinical Neuropsychologist in the Mental Health and Clinical Neuroscience Division at the US Department of Veterans Affairs (VA) Portland Health Care System in Oregon. is a Postdoctoral Fellow, is a Clinical Director, is the Director, and is the Executive Director; all at the War Related Illness and Injury Study Center; is a Clinical Neuropsychologist at the VA Memory Clinic; is a Program Analyst in Polytrauma System of Care; is an Investigator in the Sierra Pacific Mental Illness Research, Education, and Clinical Center (MIRECC): is an Associate Director, is the Director; all at the MIRECC; is a Clincial Research Senior Scientific Director in the Rehabilitation Service, all at the VA Palo Alto Health Care System in California. is a Research Data Analyst, J. Kaci Fairchild, Sherry Beaudreau, John Ashford, Jerome Yesavage, and are Professors, Dana Waltzman is a Postdoctoral Fellow, all in the Stanford Department of Psychiatry and Behavioral Sciences; is a Clinical Neuropsychologist and Clinical Assistant Professor (affiliated) in the Stanford Neuroscience Institute, and Maheen Adamson is a Clinical Associate Professor in the Department of Neurosurgery, all at Stanford University School of Medicine in California. Nathan Hantke is an Assistant Professor in the Department of Neurology at Oregon Health and Science University in Portland
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Adamson MM, Phillips A, Seenivasan S, Martinez J, Grewal H, Kang X, Coetzee J, Luttenbacher I, Jester A, Harris OA, Spiegel D. International Prevalence and Correlates of Psychological Stress during the Global COVID-19 Pandemic. Int J Environ Res Public Health 2020; 17:E9248. [PMID: 33321950 PMCID: PMC7763004 DOI: 10.3390/ijerph17249248] [Citation(s) in RCA: 33] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/21/2020] [Revised: 12/02/2020] [Accepted: 12/04/2020] [Indexed: 12/19/2022]
Abstract
This study reports perceived stress and associated sociodemographic factors from an international sample of adults, during the COVID-19 pandemic. The Perceived Stress Scale (PSS-10) along with socio-demographic questions were conducted between 8 April 2020 and 11 May 2020. The survey was translated from English into five languages. Recruitment was conducted worldwide using social media. A total of 1685 survey responses were collected across 57 countries with eleven countries (≥30 responses/country) included in the sub-analyses. Overall, the mean PSS-10 score was 19.08 (SD = 7.17), reflecting moderate stress compared to previously reported norms. Female gender was associated with a higher PSS score (3.03, p < 0.05) as well as four-year degree holders (3.29, p < 0.05), while adults over 75 years (-7.46, p < 0.05) had lower PSS scores. Personal care composite score (including hours of sleep, exercise, and meditation) was associated with lower PSS scores (-0.39, p < 0.01). Increases in personal care and changes in work expectations were associated with lower PSS scores (-1.30 (p < 0.05) and -0.38 (p < 0.01), respectively). Lower total PSS scores were reported in Germany (-4.82, p < 0.01) compared to the global response sample mean. This information, collected during the initial period of global mitigation orders, provides insight into potential mental health risks and protective factors during crises.
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Affiliation(s)
- Maheen M. Adamson
- Rehabilitation Service, Veterans Affairs Palo Alto Health Care System, Palo Alto, CA 94304, USA; (A.P.); (S.S.); (J.M.); (H.G.); (X.K.); (J.C.)
- Department of Neurosurgery, Stanford School of Medicine, Stanford, CA 94305, USA;
| | - Angela Phillips
- Rehabilitation Service, Veterans Affairs Palo Alto Health Care System, Palo Alto, CA 94304, USA; (A.P.); (S.S.); (J.M.); (H.G.); (X.K.); (J.C.)
- Department of Psychiatry & Behavioral Sciences, Stanford School of Medicine, Stanford, CA 94305, USA;
| | - Srija Seenivasan
- Rehabilitation Service, Veterans Affairs Palo Alto Health Care System, Palo Alto, CA 94304, USA; (A.P.); (S.S.); (J.M.); (H.G.); (X.K.); (J.C.)
| | - Julian Martinez
- Rehabilitation Service, Veterans Affairs Palo Alto Health Care System, Palo Alto, CA 94304, USA; (A.P.); (S.S.); (J.M.); (H.G.); (X.K.); (J.C.)
| | - Harlene Grewal
- Rehabilitation Service, Veterans Affairs Palo Alto Health Care System, Palo Alto, CA 94304, USA; (A.P.); (S.S.); (J.M.); (H.G.); (X.K.); (J.C.)
| | - Xiaojian Kang
- Rehabilitation Service, Veterans Affairs Palo Alto Health Care System, Palo Alto, CA 94304, USA; (A.P.); (S.S.); (J.M.); (H.G.); (X.K.); (J.C.)
| | - John Coetzee
- Rehabilitation Service, Veterans Affairs Palo Alto Health Care System, Palo Alto, CA 94304, USA; (A.P.); (S.S.); (J.M.); (H.G.); (X.K.); (J.C.)
- Department of Psychiatry & Behavioral Sciences, Stanford School of Medicine, Stanford, CA 94305, USA;
| | - Ines Luttenbacher
- Department of Psychology, University of Amsterdam, 1001 NH Amsterdam, The Netherlands;
| | - Ashley Jester
- Science and Engineering Libraries, Stanford Libraries, Stanford University, Stanford, CA 94305, USA;
| | - Odette A. Harris
- Department of Neurosurgery, Stanford School of Medicine, Stanford, CA 94305, USA;
| | - David Spiegel
- Department of Psychiatry & Behavioral Sciences, Stanford School of Medicine, Stanford, CA 94305, USA;
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13
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Adamson MM, Shakil S, Sultana T, Hasan MA, Mubarak F, Enam SA, Parvaz MA, Razi A. Brain Injury and Dementia in Pakistan: Current Perspectives. Front Neurol 2020; 11:299. [PMID: 32425875 PMCID: PMC7205019 DOI: 10.3389/fneur.2020.00299] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2019] [Accepted: 03/30/2020] [Indexed: 12/14/2022] Open
Abstract
Alzheimer's disease (AD) is the most common form of dementia, accounting for 50-75% of all cases, with a greater proportion of individuals affected at older age range. A single moderate or severe traumatic brain injury (TBI) is associated with accelerated aging and increased risk for dementia. The fastest growth in the elderly population is taking place in China, Pakistan, and their south Asian neighbors. Current clinical assessments are based on data collected from Caucasian populations from wealthy backgrounds giving rise to a "diversity" crisis in brain research. Pakistan is a lower-middle income country (LMIC) with an estimated one million people living with dementia. Pakistan also has an amalgamation of risk factors that lead to brain injuries such as lack of road legislations, terrorism, political instability, and domestic and sexual violence. Here, we provide an initial and current assessment of the incidence and management of dementia and TBI in Pakistan. Our review demonstrates the lack of resources in terms of speciality trained clinician staff, medical equipment, research capabilities, educational endeavors, and general awareness in the fields of dementia and TBI. Pakistan also lacks state-of-the-art assessment of dementia and its risk factors, such as neuroimaging of brain injury and aging. We provide recommendations for improvement in this arena that include the recent creation of Pakistan Brain Injury Consortium (PBIC). This consortium will enhance international collaborative efforts leading to capacity building for innovative research, clinician and research training and developing databases to bring Pakistan into the international platform for dementia and TBI research.
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Affiliation(s)
- Maheen M Adamson
- Department of Neurosurgery, Stanford University School of Medicine, Palo Alto, CA, United States.,Department of Rehabilitation, VA Palo Alto, Palo Alto, CA, United States
| | - Sadia Shakil
- Department of Electrical Engineering, Institute of Space Technology, Islamabad, Pakistan.,Turner Institute for Brain and Mental Health, and Monash Biomedical Imaging, Monash University, Clayton, VIC, Australia
| | - Tajwar Sultana
- Department of Biomedical Engineering, NED University of Engineering and Technology, Karachi, Pakistan.,Neurocomputation Laboratory, National Centre for Artificial Intelligence, NED University of Engineering and Technology, Karachi, Pakistan.,Department of Computer and Information Systems Engineering, NED University of Engineering and Technology, Karachi, Pakistan
| | - Muhammad Abul Hasan
- Department of Biomedical Engineering, NED University of Engineering and Technology, Karachi, Pakistan.,Neurocomputation Laboratory, National Centre for Artificial Intelligence, NED University of Engineering and Technology, Karachi, Pakistan
| | - Fatima Mubarak
- Department of Radiology, Aga Khan University, Karachi, Pakistan
| | - Syed Ather Enam
- Department of Surgery, Aga Khan University, Karachi, Pakistan
| | - Muhammad A Parvaz
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY, United States.,Department of Neuroscience, Icahn School of Medicine at Mount Sinai, New York, NY, United States
| | - Adeel Razi
- Turner Institute for Brain and Mental Health, and Monash Biomedical Imaging, Monash University, Clayton, VIC, Australia.,The Wellcome Centre for Human Neuroimaging, Institute of Neurology, University College London, London, United Kingdom.,Department of Electronic Engineering, NED University of Engineering and Technology, Karachi, Pakistan
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Gray M, Adamson MM, Thompson RC, Kapphahn KI, Han S, Chung JS, Harris OA. Sex differences in symptom presentation and functional outcomes: a pilot study in a matched sample of veterans with mild TBI. Brain Inj 2020; 34:535-547. [DOI: 10.1080/02699052.2020.1725979] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Affiliation(s)
- Max Gray
- Defense and Veterans Brain Injury Center (DVBIC), VA Palo Alto Health Care System (VAPAHCS), Palo Alto, CA, USA
| | - Maheen M. Adamson
- Defense and Veterans Brain Injury Center (DVBIC), VA Palo Alto Health Care System (VAPAHCS), Palo Alto, CA, USA
| | - Ryan C. Thompson
- Defense and Veterans Brain Injury Center (DVBIC), VA Palo Alto Health Care System (VAPAHCS), Palo Alto, CA, USA
| | | | - Summer Han
- Department of Neurosurgery, Stanford School of Medicine, Palo Alto, CA, USA
| | - Joyce S. Chung
- Department of Polytrauma, VA Palo Alto Health Care System (VAPAHCS), Palo Alto, CA, USA
| | - Odette A. Harris
- Defense and Veterans Brain Injury Center (DVBIC), VA Palo Alto Health Care System (VAPAHCS), Palo Alto, CA, USA
- Department of Neurosurgery, Stanford School of Medicine, Palo Alto, CA, USA
- Department of Polytrauma, VA Palo Alto Health Care System (VAPAHCS), Palo Alto, CA, USA
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15
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Adamson MM, Main KL, Milazzo AC, Soman S, Kong J, Kolakowsky-Hayner S, Furst AJ, Ashford JW, Kang X. Cortical Thickness and Diffusion Properties in the Injured Brain: The Influence of Chronic Health Complaints. Mil Med 2020; 185:168-175. [PMID: 32074336 DOI: 10.1093/milmed/usz213] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
INTRODUCTION Cortical thickness and diffusion properties can be served as an indicator of aging and other brain changes such as those related to brain injury. It can additionally provide another platform by which we can characterize the injury and its associated symptoms, especially in the chronic condition. METHODS We examined the changes in cortical thickness and diffusion properties in white matter tracts in 51 patients with and without traumatic brain injury (TBI) and/or self-report chronic symptoms. RESULTS Significant cortical thinning was observed in the frontal lobe and temporal lobe for TBI patients with chronic symptoms, but not for TBI patients without chronic symptoms, compared with control group. Significant reduction in fractional anisotropy occurred on average across left and right major fiber tracts for TBI patients with chronic symptoms. No mean diffusivity changes were found in any individual white matter tract for TBI patients with or without chronic symptoms. CONCLUSIONS Traumatic brain injury patients with chronic symptoms have more significant cortical thinning or degeneration of diffusion properties than the mild to severe TBI patients without chronic symptoms. This finding suggests that symptom reporting should be assessed in line with objective measures in clinical practice.
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Affiliation(s)
- Maheen M Adamson
- Defense and Veterans Brain Injury Center (DVBIC), Veterans Affairs Palo Alto Healthcare System (VAPAHCS), 3801 Miranda Avenue, Palo Alto, CA 94304.,Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, 401 Quarry Road, Stanford, CA 94305.,Department of Neurosurgery, Stanford University School of Medicine, 300 Pasteur Dr., Palo Alto, CA 94304
| | - Keith L Main
- Defense and Veterans Brain Injury Center (DVBIC), Veterans Affairs Palo Alto Healthcare System (VAPAHCS), 3801 Miranda Avenue, Palo Alto, CA 94304.,Defense and Veterans Brain Injury Headquarters, 1335 East West Highway Suite 6-100, Silver Spring, MD 20910.,War Related Illness and Injury Study Center, Veterans Affairs Palo Alto Health Care System, 3801 Miranda Avenue, Palo Alto, CA 94304
| | - Anna-Clare Milazzo
- Defense and Veterans Brain Injury Headquarters, 1335 East West Highway Suite 6-100, Silver Spring, MD 20910.,War Related Illness and Injury Study Center, Veterans Affairs Palo Alto Health Care System, 3801 Miranda Avenue, Palo Alto, CA 94304
| | - Salil Soman
- Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, 401 Quarry Road, Stanford, CA 94305.,War Related Illness and Injury Study Center, Veterans Affairs Palo Alto Health Care System, 3801 Miranda Avenue, Palo Alto, CA 94304.,Beth Israel Deaconess Medical Center, Harvard Medical School, 25 Shattuck St., Boston, MA 02115
| | - Jennifer Kong
- War Related Illness and Injury Study Center, Veterans Affairs Palo Alto Health Care System, 3801 Miranda Avenue, Palo Alto, CA 94304
| | - Stephanie Kolakowsky-Hayner
- Department of Rehabilitation Medicine, Icahn School of Medicine at Mt. Sinai, 1 Gustave L. Levy Pl, New York, NY 10029
| | - Ansgar J Furst
- War Related Illness and Injury Study Center, Veterans Affairs Palo Alto Health Care System, 3801 Miranda Avenue, Palo Alto, CA 94304.,Department of Neurology and Neurological Sciences, Stanford University School of Medicine, 300 Pasteur Dr., Palo Alto, CA 94304
| | - J Wesson Ashford
- Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, 401 Quarry Road, Stanford, CA 94305.,War Related Illness and Injury Study Center, Veterans Affairs Palo Alto Health Care System, 3801 Miranda Avenue, Palo Alto, CA 94304
| | - Xiaojian Kang
- Defense and Veterans Brain Injury Center (DVBIC), Veterans Affairs Palo Alto Healthcare System (VAPAHCS), 3801 Miranda Avenue, Palo Alto, CA 94304
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16
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Taylor JL, Hambro BC, Strossman ND, Bhatt P, Hernandez B, Ashford JW, Cheng JJ, Iv M, Adamson MM, Lazzeroni LC, McNerney MW. The effects of repetitive transcranial magnetic stimulation in older adults with mild cognitive impairment: a protocol for a randomized, controlled three-arm trial. BMC Neurol 2019; 19:326. [PMID: 31842821 PMCID: PMC6912947 DOI: 10.1186/s12883-019-1552-7] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2019] [Accepted: 12/03/2019] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Mild Cognitive Impairment (MCI) carries a high risk of progression to Alzheimer's disease (AD) dementia. Previous clinical trials testing whether cholinesterase inhibitors can slow the rate of progression from MCI to AD dementia have yielded disappointing results. However, recent studies of the effects of repetitive transcranial magnetic stimulation (rTMS) in AD have demonstrated improvements in cognitive function. Because few rTMS trials have been conducted in MCI, we designed a trial to test the short-term efficacy of rTMS in MCI. Yet, in both MCI and AD, we know little about what site of stimulation would be ideal for improving cognitive function. Therefore, two cortical sites will be investigated in this trial: (1) the dorsolateral prefrontal cortex (DLPFC), which has been well studied for treatment of major depressive disorder; and (2) the lateral parietal cortex (LPC), a novel site with connectivity to AD-relevant limbic regions. METHODS/DESIGN In this single-site trial, we plan to enroll 99 participants with single or multi-domain amnestic MCI. We will randomize participants to one of three groups: (1) Active DLPFC rTMS; (2) Active LPC rTMS; and (3) Sham rTMS (evenly split between DLPFC and LPC locations). After completing 20 bilateral rTMS treatment sessions, participants will be followed for 6 months to test short-term efficacy and track durability of effects. The primary efficacy measure is the California Verbal Learning Test-II (CVLT-II), assessed 1 week after intervention. Secondary analyses will examine effects of rTMS on other cognitive measures, symptoms of depression, and brain function with respect to the site of stimulation. Finally, selected biomarkers will be analyzed to explore predictors of response and mechanisms of action. DISCUSSION The primary aim of this trial is to test the short-term efficacy of rTMS in MCI. Additionally, the project will provide information on the durability of cognitive effects and potentially distinct effects of stimulating DLPFC versus LPC regions. Future efforts would be directed toward better understanding therapeutic mechanisms and optimizing rTMS for treatment of MCI. Ultimately, if rTMS can be utilized to slow the rate of progression to AD dementia, this will be a significant advancement in the field. TRIAL REGISTRATION Clinical Trials NCT03331796. Registered 6 November 2017, https://clinicaltrials.gov/ct2/show/NCT03331796. All items from the World Health Organization Trial Registration Data Set are listed in Appendix A. PROTOCOL VERSION This report is based on version 1, approved by the DSMB on 30 November, 2017 and amended on 14 August, 2018 and 19 September, 2019.
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Affiliation(s)
- Joy L. Taylor
- US Department of Veterans Affairs (VA) Palo Alto Health Care System (151Y), Sierra-Pacific Mental Illness Research Education Clinical Center (MIRECC), 3801 Miranda Avenue, Palo Alto, CA 94304-1207 USA
- Department of Psychiatry and Behavioral Sciences, Stanford University, School of Medicine, Stanford, CA USA
| | - Benjamin C. Hambro
- US Department of Veterans Affairs (VA) Palo Alto Health Care System (151Y), Sierra-Pacific Mental Illness Research Education Clinical Center (MIRECC), 3801 Miranda Avenue, Palo Alto, CA 94304-1207 USA
| | - Nicole D. Strossman
- US Department of Veterans Affairs (VA) Palo Alto Health Care System (151Y), Sierra-Pacific Mental Illness Research Education Clinical Center (MIRECC), 3801 Miranda Avenue, Palo Alto, CA 94304-1207 USA
| | - Priyanka Bhatt
- US Department of Veterans Affairs (VA) Palo Alto Health Care System (151Y), Sierra-Pacific Mental Illness Research Education Clinical Center (MIRECC), 3801 Miranda Avenue, Palo Alto, CA 94304-1207 USA
| | - Beatriz Hernandez
- US Department of Veterans Affairs (VA) Palo Alto Health Care System (151Y), Sierra-Pacific Mental Illness Research Education Clinical Center (MIRECC), 3801 Miranda Avenue, Palo Alto, CA 94304-1207 USA
- Department of Psychiatry and Behavioral Sciences, Stanford University, School of Medicine, Stanford, CA USA
| | - J. Wesson Ashford
- Department of Psychiatry and Behavioral Sciences, Stanford University, School of Medicine, Stanford, CA USA
- War Related Illness and Injury Study Center (WRIISC), VA Palo Alto Health Care System, Palo Alto, CA USA
| | - Jauhtai Joseph Cheng
- US Department of Veterans Affairs (VA) Palo Alto Health Care System (151Y), Sierra-Pacific Mental Illness Research Education Clinical Center (MIRECC), 3801 Miranda Avenue, Palo Alto, CA 94304-1207 USA
- Department of Psychiatry and Behavioral Sciences, Stanford University, School of Medicine, Stanford, CA USA
| | - Michael Iv
- Department of Radiology, Division of Neuroimaging and Neurointervention, Stanford University Medical Center, Stanford, CA USA
| | - Maheen M. Adamson
- Department of Psychiatry and Behavioral Sciences, Stanford University, School of Medicine, Stanford, CA USA
- Defense and Veterans Brain Injury Center and Polytrauma (DVBIC), VA Palo Alto Health Care System, Palo Alto, CA USA
| | - Laura C. Lazzeroni
- Department of Psychiatry and Behavioral Sciences, Stanford University, School of Medicine, Stanford, CA USA
| | - Margaret Windy McNerney
- US Department of Veterans Affairs (VA) Palo Alto Health Care System (151Y), Sierra-Pacific Mental Illness Research Education Clinical Center (MIRECC), 3801 Miranda Avenue, Palo Alto, CA 94304-1207 USA
- Department of Psychiatry and Behavioral Sciences, Stanford University, School of Medicine, Stanford, CA USA
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17
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Kim LH, Quon JL, Sun FW, Wortman KM, Adamson MM, Harris OA. Traumatic brain injury among female veterans: a review of sex differences in military neurosurgery. Neurosurg Focus 2019; 45:E16. [PMID: 30544324 DOI: 10.3171/2018.9.focus18369] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2018] [Accepted: 09/10/2018] [Indexed: 11/06/2022]
Abstract
The impact of traumatic brain injury (TBI) has been demonstrated in various studies with respect to prevalence, morbidity, and mortality data. Many of the patients burdened with long-term sequelae of TBI are veterans. Although fewer in number, female veterans with TBI have been suggested to suffer from unique physical, mental, and social challenges. However, there remains a significant knowledge gap in the sex differences in TBI. Increased female representation in the military heralds an increased risk of TBI for female soldiers, and medical professionals must be prepared to address the unique health challenges in the face of changing demographics among the veteran TBI population. In this review, the authors aimed to present the current understanding of sex differences in TBI in the veteran population and suggest directions for future investigations.
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Affiliation(s)
- Lily H Kim
- 1The Defense and Veterans Brain Injury Center, VA Palo Alto Health Care System, Palo Alto.,2Department of Neurosurgery, Stanford University School of Medicine, Stanford, California; and
| | - Jennifer L Quon
- 2Department of Neurosurgery, Stanford University School of Medicine, Stanford, California; and
| | - Felicia W Sun
- 1The Defense and Veterans Brain Injury Center, VA Palo Alto Health Care System, Palo Alto.,3College of Medicine, University of Illinois, Chicago, Illinois
| | - Kristen M Wortman
- 1The Defense and Veterans Brain Injury Center, VA Palo Alto Health Care System, Palo Alto
| | - Maheen M Adamson
- 1The Defense and Veterans Brain Injury Center, VA Palo Alto Health Care System, Palo Alto.,2Department of Neurosurgery, Stanford University School of Medicine, Stanford, California; and
| | - Odette A Harris
- 1The Defense and Veterans Brain Injury Center, VA Palo Alto Health Care System, Palo Alto.,2Department of Neurosurgery, Stanford University School of Medicine, Stanford, California; and
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18
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Soman S, Liu Z, Kim G, Nemec U, Holdsworth SJ, Main K, Lee B, Kolakowsky-Hayner S, Selim M, Furst AJ, Massaband P, Yesavage J, Adamson MM, Spincemaille P, Moseley M, Wang Y. Brain Injury Lesion Imaging Using Preconditioned Quantitative Susceptibility Mapping without Skull Stripping. AJNR Am J Neuroradiol 2018; 39:648-653. [PMID: 29472296 DOI: 10.3174/ajnr.a5550] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2017] [Accepted: 12/04/2017] [Indexed: 11/07/2022]
Abstract
BACKGROUND AND PURPOSE Identifying cerebral microhemorrhage burden can aid in the diagnosis and management of traumatic brain injury, stroke, hypertension, and cerebral amyloid angiopathy. MR imaging susceptibility-based methods are more sensitive than CT for detecting cerebral microhemorrhage, but methods other than quantitative susceptibility mapping provide results that vary with field strength and TE, require additional phase maps to distinguish blood from calcification, and depict cerebral microhemorrhages as bloom artifacts. Quantitative susceptibility mapping provides universal quantification of tissue magnetic property without these constraints but traditionally requires a mask generated by skull-stripping, which can pose challenges at tissue interphases. We evaluated the preconditioned quantitative susceptibility mapping MR imaging method, which does not require skull-stripping, for improved depiction of brain parenchyma and pathology. MATERIALS AND METHODS Fifty-six subjects underwent brain MR imaging with a 3D multiecho gradient recalled echo acquisition. Mask-based quantitative susceptibility mapping images were created using a commonly used mask-based quantitative susceptibility mapping method, and preconditioned quantitative susceptibility images were made using precondition-based total field inversion. All images were reviewed by a neuroradiologist and a radiology resident. RESULTS Ten subjects (18%), all with traumatic brain injury, demonstrated blood products on 3D gradient recalled echo imaging. All lesions were visible on preconditioned quantitative susceptibility mapping, while 6 were not visible on mask-based quantitative susceptibility mapping. Thirty-one subjects (55%) demonstrated brain parenchyma and/or lesions that were visible on preconditioned quantitative susceptibility mapping but not on mask-based quantitative susceptibility mapping. Six subjects (11%) demonstrated pons artifacts on preconditioned quantitative susceptibility mapping and mask-based quantitative susceptibility mapping; they were worse on preconditioned quantitative susceptibility mapping. CONCLUSIONS Preconditioned quantitative susceptibility mapping MR imaging can bring the benefits of quantitative susceptibility mapping imaging to clinical practice without the limitations of mask-based quantitative susceptibility mapping, especially for evaluating cerebral microhemorrhage-associated pathologies, such as traumatic brain injury.
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Affiliation(s)
- S Soman
- From the Departments of Radiology (S.S., G.K., B.L.)
| | - Z Liu
- Department of Biomedical Engineering (Z.L., Y.W.), Cornell University, New York, New York
| | - G Kim
- From the Departments of Radiology (S.S., G.K., B.L.)
| | - U Nemec
- Department of Biomedical Imaging and Image-Guided Therapy (U.N.), Medical University of Vienna, Vienna, Austria
| | | | - K Main
- Research Division, Defense and Veterans Brain Injury Center (K.M.), General Dynamics Health Solutions, Silver Spring, Maryland
| | - B Lee
- From the Departments of Radiology (S.S., G.K., B.L.)
| | - S Kolakowsky-Hayner
- Department of Rehabilitation Medicine (S.K.-H.), Icahn School of Medicine at Mount Sinai, New York, New York
| | - M Selim
- Neurology (M.S.), Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts
| | - A J Furst
- Psychiatry and Behavioral Sciences (A.J.F., J.Y., M.M.A.)
- Departments of Psychiatry (A.J.F., J.Y.)
| | - P Massaband
- Departments of Radiology (S.J.H., P.M., M.M.)
- Radiology (P.M.)
| | - J Yesavage
- Psychiatry and Behavioral Sciences (A.J.F., J.Y., M.M.A.)
- Departments of Psychiatry (A.J.F., J.Y.)
| | - M M Adamson
- Psychiatry and Behavioral Sciences (A.J.F., J.Y., M.M.A.)
- Neurosurgery (M.M.A.), Stanford University, Stanford, California
- Defense and Veterans Brain Injury Center (M.M.A.), VA Palo Alto Health Care System, Palo Alto, California
| | - P Spincemaille
- Department of Radiology (P.S., Y.W.), Weil Cornell Medical College, New York, New York
| | - M Moseley
- Departments of Radiology (S.J.H., P.M., M.M.)
| | - Y Wang
- Department of Biomedical Engineering (Z.L., Y.W.), Cornell University, New York, New York
- Department of Radiology (P.S., Y.W.), Weil Cornell Medical College, New York, New York
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Hantke NC, Gyurak A, Van Moorleghem K, Waring JD, Adamson MM, O'Hara R, Beaudreau SA. Disentangling cognition and emotion in older adults: the role of cognitive control and mental health in emotional conflict adaptation. Int J Geriatr Psychiatry 2017; 32:840-848. [PMID: 27445036 DOI: 10.1002/gps.4535] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/06/2015] [Revised: 05/31/2016] [Accepted: 06/02/2016] [Indexed: 11/06/2022]
Abstract
OBJECTIVE Recent research suggests cognition has a bidirectional relationship with emotional processing in older adults, yet the relationship is still poorly understood. We aimed to examine a potential relationship between late-life cognitive function, mental health symptoms, and emotional conflict adaptation. We hypothesized that worse cognitive control abilities would be associated with poorer emotional conflict adaptation. We further hypothesized that a higher severity of mental health symptoms would be associated with poorer emotional conflict adaptation. METHODS Participants included 83 cognitively normal community-dwelling older adults who completed a targeted mental health and cognitive battery, and emotion and gender conflict-adaptation tasks. RESULTS Consistent with our hypothesis, poorer performance on components of cognitive control, specifically attention and working memory, was associated with poorer emotional conflict adaptation. This association with attention and working memory was not observed in the non-affective-based gender conflict adaptation task. Mental health symptoms did not predict emotional conflict adaptation, nor did performance on other cognitive measures. CONCLUSION Our findings suggest that emotion conflict adaptation is disrupted in older individuals who have poorer attention and working memory. Components of cognitive control may therefore be an important potential source of inter-individual differences in late-life emotion regulation and cognitive affective deficits. Copyright © 2016 John Wiley & Sons, Ltd.
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Affiliation(s)
- Nathan C Hantke
- Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, Stanford, CA, USA.,Sierra Pacific Mental Illness Research Education and Clinical Center (MIRECC), Palo Alto VA Health Care System, Palo Alto, CA, USA.,War Related Illness and Injury Study Center (WRIISC), VA Palo Alto Health Care System, Palo Alto, CA, USA
| | - Anett Gyurak
- Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, Stanford, CA, USA.,Sierra Pacific Mental Illness Research Education and Clinical Center (MIRECC), Palo Alto VA Health Care System, Palo Alto, CA, USA
| | | | - Jill D Waring
- Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, Stanford, CA, USA.,Sierra Pacific Mental Illness Research Education and Clinical Center (MIRECC), Palo Alto VA Health Care System, Palo Alto, CA, USA.,Department of Psychology, Saint Louis University, Saint Louis, MO, USA
| | - Maheen M Adamson
- Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, Stanford, CA, USA.,War Related Illness and Injury Study Center (WRIISC), VA Palo Alto Health Care System, Palo Alto, CA, USA
| | - Ruth O'Hara
- Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, Stanford, CA, USA.,Sierra Pacific Mental Illness Research Education and Clinical Center (MIRECC), Palo Alto VA Health Care System, Palo Alto, CA, USA.,University of Queensland, Brisbane, Australia
| | - Sherry A Beaudreau
- Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, Stanford, CA, USA.,Sierra Pacific Mental Illness Research Education and Clinical Center (MIRECC), Palo Alto VA Health Care System, Palo Alto, CA, USA.,University of Queensland, Brisbane, Australia
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20
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Main KL, Soman S, Pestilli F, Furst A, Noda A, Hernandez B, Kong J, Cheng J, Fairchild JK, Taylor J, Yesavage J, Wesson Ashford J, Kraemer H, Adamson MM. DTI measures identify mild and moderate TBI cases among patients with complex health problems: A receiver operating characteristic analysis of U.S. veterans. Neuroimage Clin 2017; 16:1-16. [PMID: 28725550 PMCID: PMC5503837 DOI: 10.1016/j.nicl.2017.06.031] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2016] [Revised: 06/10/2017] [Accepted: 06/23/2017] [Indexed: 01/10/2023]
Abstract
Standard MRI methods are often inadequate for identifying mild traumatic brain injury (TBI). Advances in diffusion tensor imaging now provide potential biomarkers of TBI among white matter fascicles (tracts). However, it is still unclear which tracts are most pertinent to TBI diagnosis. This study ranked fiber tracts on their ability to discriminate patients with and without TBI. We acquired diffusion tensor imaging data from military veterans admitted to a polytrauma clinic (Overall n = 109; Age: M = 47.2, SD = 11.3; Male: 88%; TBI: 67%). TBI diagnosis was based on self-report and neurological examination. Fiber tractography analysis produced 20 fiber tracts per patient. Each tract yielded four clinically relevant measures (fractional anisotropy, mean diffusivity, radial diffusivity, and axial diffusivity). We applied receiver operating characteristic (ROC) analyses to identify the most diagnostic tract for each measure. The analyses produced an optimal cutpoint for each tract. We then used kappa coefficients to rate the agreement of each cutpoint with the neurologist's diagnosis. The tract with the highest kappa was most diagnostic. As a check on the ROC results, we performed a stepwise logistic regression on each measure using all 20 tracts as predictors. We also bootstrapped the ROC analyses to compute the 95% confidence intervals for sensitivity, specificity, and the highest kappa coefficients. The ROC analyses identified two fiber tracts as most diagnostic of TBI: the left cingulum (LCG) and the left inferior fronto-occipital fasciculus (LIF). Like ROC, logistic regression identified LCG as most predictive for the FA measure but identified the right anterior thalamic tract (RAT) for the MD, RD, and AD measures. These findings are potentially relevant to the development of TBI biomarkers. Our methods also demonstrate how ROC analysis may be used to identify clinically relevant variables in the TBI population.
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Key Words
- AD, axial diffusivity
- Axon degeneration
- CC, corpus callosum
- Concussion
- DAI, diffuse axonal injury
- DTI, diffusion tensor imaging
- FA, fractional anisotropy
- GN, genu
- Imaging
- LAT, left anterior thalamic tract
- LCG, left cingulum
- LCH, left cingulum – hippocampus
- LCS, left cortico-spinal tract
- LIF, left inferior fronto-occipital fasciculus
- LIL, left inferior longitudinal fasciculus
- LSL, left superior longitudinal fasciculus
- LST, left superior longitudinal fasciculus – temporal
- LUN, left uncinate
- MD, mean diffusivity
- Neurodegeneration
- PTSD, post-traumatic stress disorder
- RAT, right anterior thalamic tract
- RCG, right cingulum
- RCH, right cingulum – Hippocampus
- RCS, right cortico-spinal tract
- RD, radial diffusivity
- RIF, right inferior fronto-occipital fasciculus
- RIL, right inferior longitudinal fasciculus
- ROC, receiver operating characteristic
- RSL, right superior longitudinal fasciculus
- RST, right superior longitudinal fasciculus – temporal
- RUN, right uncinate
- SP, splenium
- TBI, traumatic brain injury
- Traumatic brain injury
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Affiliation(s)
- Keith L. Main
- War Related Illness and Injury Study Center, Veterans Affairs, Palo Alto Health Care System (VAPAHCS), Palo Alto, CA, United States
- Defense and Veterans Brain Injury Center (DVBIC), Silver Spring, MD, United States
- General Dynamics Health Solutions (GDHS), Fairfax, VA, United States
| | - Salil Soman
- War Related Illness and Injury Study Center, Veterans Affairs, Palo Alto Health Care System (VAPAHCS), Palo Alto, CA, United States
- Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, Stanford, CA, United States
- Department of Radiology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, United States
| | - Franco Pestilli
- Department of Psychological and Brain Sciences, Indiana University, Bloomington, IN, United States
| | - Ansgar Furst
- War Related Illness and Injury Study Center, Veterans Affairs, Palo Alto Health Care System (VAPAHCS), Palo Alto, CA, United States
- Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, Stanford, CA, United States
- Department of Neurology and Neurological Sciences, Stanford University School of Medicine, Stanford, CA, United States
| | - Art Noda
- Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, Stanford, CA, United States
| | - Beatriz Hernandez
- Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, Stanford, CA, United States
| | - Jennifer Kong
- War Related Illness and Injury Study Center, Veterans Affairs, Palo Alto Health Care System (VAPAHCS), Palo Alto, CA, United States
| | - Jauhtai Cheng
- War Related Illness and Injury Study Center, Veterans Affairs, Palo Alto Health Care System (VAPAHCS), Palo Alto, CA, United States
| | - Jennifer K. Fairchild
- Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, Stanford, CA, United States
| | - Joy Taylor
- Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, Stanford, CA, United States
| | - Jerome Yesavage
- War Related Illness and Injury Study Center, Veterans Affairs, Palo Alto Health Care System (VAPAHCS), Palo Alto, CA, United States
- Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, Stanford, CA, United States
| | - J. Wesson Ashford
- War Related Illness and Injury Study Center, Veterans Affairs, Palo Alto Health Care System (VAPAHCS), Palo Alto, CA, United States
- Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, Stanford, CA, United States
| | - Helena Kraemer
- Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, Stanford, CA, United States
| | - Maheen M. Adamson
- Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, Stanford, CA, United States
- Department of Neurosurgery, Stanford School of Medicine, Stanford, CA, United States
- Defense and Veterans Brain Injury Center (DVBIC), Veterans Affairs, Palo Alto Health Care System (VAPAHCS), Palo Alto, CA, United States
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21
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Schulz-Heik RJ, Poole JH, Dahdah MN, Sullivan C, Adamson MM, Date ES, Salerno R, Schwab K, Harris O. Service needs and barriers to care five or more years after moderate to severe TBI among Veterans. Brain Inj 2017; 31:1287-1293. [DOI: 10.1080/02699052.2017.1307449] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Affiliation(s)
- R. Jay Schulz-Heik
- Defense and Veterans Brain Injury Center, Palo Alto, CA and Rockville, MD, USA
- VA Palo Alto Healthcare System, Palo Alto, CA, USA
| | - John H. Poole
- Defense and Veterans Brain Injury Center, Palo Alto, CA and Rockville, MD, USA
- VA Palo Alto Healthcare System, Palo Alto, CA, USA
| | - Marie N. Dahdah
- Baylor Institute for Rehabilitation, Dallas, TX, USA
- Baylor Regional Medical Center at Plano, Plano, TX, USA
| | - Campbell Sullivan
- Johns Hopkins University School of Medicine, Baltimore, MD, USA
- Sinai Hospital of Baltimore, Baltimore, MD, USA
| | - Maheen M. Adamson
- Defense and Veterans Brain Injury Center, Palo Alto, CA and Rockville, MD, USA
- VA Palo Alto Healthcare System, Palo Alto, CA, USA
- Stanford University School of Medicine, Palo Alto, CA, USA
| | | | - Rose Salerno
- Defense and Veterans Brain Injury Center, Palo Alto, CA and Rockville, MD, USA
- VA Palo Alto Healthcare System, Palo Alto, CA, USA
| | - Karen Schwab
- Defense and Veterans Brain Injury Center, Palo Alto, CA and Rockville, MD, USA
| | - Odette Harris
- Defense and Veterans Brain Injury Center, Palo Alto, CA and Rockville, MD, USA
- VA Palo Alto Healthcare System, Palo Alto, CA, USA
- Stanford University School of Medicine, Palo Alto, CA, USA
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22
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Soman S, Bregni JA, Bilgic B, Nemec U, Fan A, Liu Z, Barry RL, Du J, Main K, Yesavage J, Adamson MM, Moseley M, Wang Y. Susceptibility-Based Neuroimaging: Standard Methods, Clinical Applications, and Future Directions. Curr Radiol Rep 2017; 5. [PMID: 28695062 DOI: 10.1007/s40134-017-0204-1] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
The evaluation of neuropathologies using MRI methods that leverage tissue susceptibility have become standard practice, especially to detect blood products or mineralization. Additionally, emerging MRI techniques have the ability to provide new information based on tissue susceptibility properties in a robust and quantitative manner. This paper discusses these advanced susceptibility imaging techniques and their clinical applications.
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Affiliation(s)
- Salil Soman
- Department of Radiology, Beth Israel Deaconess Medical Center, Harvard Medical School, Rosenberg 90A, 1 Deaconess Road, Boston, MA 02215, Tel: 617-754-2009
| | | | - Berkin Bilgic
- Department of Radiology, Massachusetts General Hospital, Harvard Medical School, A.A. Martinos Center for Biomedical Imaging 149 13th Street, Room 2.102, Charlestown, MA 02129, Tel: 617-866-8740
| | - Ursula Nemec
- Department of Radiology, Medical University of Vienna, Austria
| | - Audrey Fan
- Department of Radiology, Stanford School of Medicine 300 Pasteur Dr, MC 5105, Stanford, CA94305
| | - Zhe Liu
- Cornell MRI Research Lab, Cornell University, 515 East 71st St, Suite 104, New York, NY 10021, ,
| | - Robert L Barry
- Department of Radiology, Massachusetts General Hospital, Harvard Medical School, A.A. Martinos Center for Biomedical Imaging 149 13th Street, Suite 2.301, Charlestown, MA 02129 USA, Tel: 615-801-0795
| | - Jiang Du
- Department of Radiology, UCSD, 200 West Arbor Drive, San Diego, CA 92103-8226, Tel: 619-471-0519
| | - Keith Main
- Principal Scientist (SME), Research Division, Defense and Veterans Brain Injury Center, General Dynamics Health Solutions, 1335 East-West Hwy, Suite 4-100, Silver Spring, MD 20910
| | - Jerome Yesavage
- Department of Psychiatry & Behavioral Sciences, Stanford School of Medicine, Mail Code 151-Y, 3801 Miranda Avenue, Palo Alto, California 94304, Phone (650) 852-3287
| | - Maheen M Adamson
- Department of Neurosurgery, Department of Psychiatry & Behavioral Sciences, Stanford School of Medicine, Defense and Veterans Brain Injury Center, VA Palo Alto Health Care System (PSC/117), 3801 Miranda Avenue (151Y), Palo Alto, CA 94304
| | - Michael Moseley
- Department of Radiology, Stanford School of Medicine, Mail Code 5488, Route 8, Rm PS059, Stanford, CA, 94305-5488, Tel: 650-725-6077
| | - Yi Wang
- Department of Radiology, Cornell Medical School, Department of Biomedical Engineering, Cornell University, 301 Weill Hall, 237 Tower Road, Ithaca, NY 14853, Tel: 646 962-2631
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23
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Waltzman D, Soman S, Hantke NC, Fairchild JK, Kinoshita LM, Wintermark M, Ashford JW, Yesavage J, Williams L, Adamson MM, Furst AJ. Altered Microstructural Caudate Integrity in Posttraumatic Stress Disorder but Not Traumatic Brain Injury. PLoS One 2017; 12:e0170564. [PMID: 28114393 PMCID: PMC5256941 DOI: 10.1371/journal.pone.0170564] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2016] [Accepted: 01/08/2017] [Indexed: 12/30/2022] Open
Abstract
Objective Given the high prevalence and comorbidity of combat-related PTSD and TBI in Veterans, it is often difficult to disentangle the contributions of each disorder. Examining these pathologies separately may help to understand the neurobiological basis of memory impairment in PTSD and TBI independently of each other. Thus, we investigated whether a) PTSD and TBI are characterized by subcortical structural abnormalities by examining diffusion tensor imaging (DTI) metrics and volume and b) if these abnormalities were specific to PTSD versus TBI. Method We investigated whether individuals with PTSD or TBI display subcortical structural abnormalities in memory regions by examining DTI metrics and volume of the hippocampus and caudate in three groups of Veterans: Veterans with PTSD, Veterans with TBI, and Veterans with neither PTSD nor TBI (Veteran controls). Results While our results demonstrated no macrostructural differences among the groups in these regions, there were significant alterations in microstructural DTI indices in the caudate for the PTSD group but not the TBI group compared to Veteran controls. Conclusions The result of increased mean, radial, and axial diffusivity, and decreased fractional anisotropy in the caudate in absence of significant volume atrophy in the PTSD group suggests the presence of subtle abnormalities evident only at a microstructural level. The caudate is thought to play a role in the physiopathology of PTSD, and the habit-like behavioral features of the disorder could be due to striatal-dependent habit learning mechanisms. Thus, DTI appears to be a vital tool to investigate subcortical pathology, greatly enhancing the ability to detect subtle brain changes in complex disorders.
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Affiliation(s)
- Dana Waltzman
- War Related Illness and Injury Study Center (WRIISC), Veterans Affairs Palo Alto Health Care System (VAPAHCS), Palo Alto, United States of America
- Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, Palo Alto, United States of America
- * E-mail:
| | - Salil Soman
- Department of Radiology, Harvard University, Cambridge, United States of America
| | - Nathan C. Hantke
- War Related Illness and Injury Study Center (WRIISC), Veterans Affairs Palo Alto Health Care System (VAPAHCS), Palo Alto, United States of America
- Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, Palo Alto, United States of America
- Sierra Pacific Mental Illness Research Education and Clinical Center (MIRECC), Veterans Affairs Palo Alto Health Care System (VAPAHCS), Palo Alto, United States of America
| | - J. Kaci Fairchild
- War Related Illness and Injury Study Center (WRIISC), Veterans Affairs Palo Alto Health Care System (VAPAHCS), Palo Alto, United States of America
- Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, Palo Alto, United States of America
- Sierra Pacific Mental Illness Research Education and Clinical Center (MIRECC), Veterans Affairs Palo Alto Health Care System (VAPAHCS), Palo Alto, United States of America
| | - Lisa M. Kinoshita
- Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, Palo Alto, United States of America
- Psychology Service, Veterans Affairs Palo Alto Health Care System (VAPAHCS), Palo Alto, United States of America
| | - Max Wintermark
- Department of Radiology, Stanford University School of Medicine, Palo Alto, United States of America
- Department of Neurology and Neurological Sciences, Stanford University School of Medicine, Palo Alto, United States of America
| | - J. Wesson Ashford
- War Related Illness and Injury Study Center (WRIISC), Veterans Affairs Palo Alto Health Care System (VAPAHCS), Palo Alto, United States of America
- Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, Palo Alto, United States of America
| | - Jerome Yesavage
- War Related Illness and Injury Study Center (WRIISC), Veterans Affairs Palo Alto Health Care System (VAPAHCS), Palo Alto, United States of America
- Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, Palo Alto, United States of America
| | - Leanne Williams
- War Related Illness and Injury Study Center (WRIISC), Veterans Affairs Palo Alto Health Care System (VAPAHCS), Palo Alto, United States of America
- Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, Palo Alto, United States of America
| | - Maheen M. Adamson
- Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, Palo Alto, United States of America
- Defense Veterans Brain Injury Center (DVBIC), Veterans Affairs Palo Alto Health Care System (VAPAHCS), Palo Alto, United States of America
| | - Ansgar J. Furst
- War Related Illness and Injury Study Center (WRIISC), Veterans Affairs Palo Alto Health Care System (VAPAHCS), Palo Alto, United States of America
- Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, Palo Alto, United States of America
- Department of Neurology and Neurological Sciences, Stanford University School of Medicine, Palo Alto, United States of America
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24
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Waltzman D, Madore M, McNerney MW, Durazzo TC, Bhat JV, Yesavage J, Adamson MM, Furst AJ. Preliminary Investigation of Sex Differences in Procedural Skill Learning in Veterans with Co-Morbidities. ACTA ACUST UNITED AC 2017. [DOI: 10.4236/jbbs.2017.78024] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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25
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Sheng T, Fairchild JK, Kong JY, Kinoshita LM, Cheng JJ, Yesavage JA, Helmer DA, Reinhard MJ, Ashford JW, Adamson MM. The influence of physical and mental health symptoms on Veterans’ functional health status. ACTA ACUST UNITED AC 2016; 53:781-796. [DOI: 10.1682/jrrd.2015.07.0146] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2015] [Revised: 03/30/2016] [Indexed: 11/05/2022]
Affiliation(s)
- Tong Sheng
- War Related Illness and Injury Study Center, VA Palo Alto Health Care System, Palo Alto, CA
- Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, Stanford, CA
| | - J. Kaci Fairchild
- War Related Illness and Injury Study Center, VA Palo Alto Health Care System, Palo Alto, CA
- Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, Stanford, CA
| | | | - Lisa M. Kinoshita
- War Related Illness and Injury Study Center, VA Palo Alto Health Care System, Palo Alto, CA
| | - Jauhtai J. Cheng
- War Related Illness and Injury Study Center, VA Palo Alto Health Care System, Palo Alto, CA
- Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, Stanford, CA
| | - Jerome A. Yesavage
- War Related Illness and Injury Study Center, VA Palo Alto Health Care System, Palo Alto, CA
- Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, Stanford, CA
| | - Drew A. Helmer
- War Related Illness and Injury Study Center, VA New Jersey Health Care System, East Orange, NJ
| | - Matthew J. Reinhard
- War Related Illness and Injury Study Center, VA Medical Center, Washington DC
| | - J. Wesson Ashford
- War Related Illness and Injury Study Center, VA Palo Alto Health Care System, Palo Alto, CA
- Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, Stanford, CA
| | - Maheen M. Adamson
- War Related Illness and Injury Study Center, VA Palo Alto Health Care System, Palo Alto, CA
- Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, Stanford, CA
- Defense and Veterans Brain Injury Center, VA Palo Alto Health Care System, Palo Alto, CA
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26
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Isaac L, Main KL, Soman S, Gotlib IH, Furst AJ, Kinoshita LM, Fairchild JK, Yesavage JA, Ashford JW, Bayley PJ, Adamson MM. The impact of depression on Veterans with PTSD and traumatic brain injury: a diffusion tensor imaging study. Biol Psychol 2015; 105:20-8. [PMID: 25559772 DOI: 10.1016/j.biopsycho.2014.12.011] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2014] [Revised: 12/15/2014] [Accepted: 12/23/2014] [Indexed: 12/20/2022]
Abstract
A significant proportion of military personnel deployed in support of Operation Enduring Freedom and Operation Iraqi Freedom were exposed to war-zone events associated with traumatic brain injury (TBI), depression (DEP) and posttraumatic stress disorder (PTSD). The co-occurrence of TBI, PTSD and DEP in returning Veterans has recently increased research and clinical interest. This study tested the hypothesis that white matter abnormalities are further impacted by depression. Of particular relevance is the uncinate fasciculus (UF), which is a key fronto-temporal tract involved in mood regulation, and the cingulum; a tract that connects to the hippocampus involved in memory integration. Diffusion tensor imaging (DTI) was performed on 25 patients with a combination of PTSD, TBI and DEP and 20 patients with PTSD and TBI (no DEP). Microstructural changes of white matter were found in the cingulum and UF. Fractional anisotropy (FA) was lower in Veterans with DEP compared to those without DEP.
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Affiliation(s)
- Linda Isaac
- War Related Illness and Injury Study Center, The Veterans Affairs Palo Alto HealthCare System, Palo Alto, USA; Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, Stanford, CA, USA.
| | - Keith L Main
- War Related Illness and Injury Study Center, The Veterans Affairs Palo Alto HealthCare System, Palo Alto, USA; Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, Stanford, CA, USA
| | - Salil Soman
- War Related Illness and Injury Study Center, The Veterans Affairs Palo Alto HealthCare System, Palo Alto, USA; Department of Radiology, Stanford University, Stanford, CA, USA
| | - Ian H Gotlib
- Department of Psychology, Stanford University, Stanford, CA, USA
| | - Ansgar J Furst
- War Related Illness and Injury Study Center, The Veterans Affairs Palo Alto HealthCare System, Palo Alto, USA; Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, Stanford, CA, USA; Department of Neurology and Neurological Sciences, Stanford University, Stanford, CA, USA
| | - Lisa M Kinoshita
- The Veterans Affairs Palo Alto HealthCare System, Palo Alto, USA
| | - J Kaci Fairchild
- Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, Stanford, CA, USA; The Veterans Affairs Palo Alto HealthCare System, Palo Alto, USA
| | - Jerome A Yesavage
- Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, Stanford, CA, USA; The Veterans Affairs Palo Alto HealthCare System, Palo Alto, USA
| | - J Wesson Ashford
- War Related Illness and Injury Study Center, The Veterans Affairs Palo Alto HealthCare System, Palo Alto, USA; Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, Stanford, CA, USA
| | - Peter J Bayley
- War Related Illness and Injury Study Center, The Veterans Affairs Palo Alto HealthCare System, Palo Alto, USA; Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, Stanford, CA, USA
| | - Maheen M Adamson
- War Related Illness and Injury Study Center, The Veterans Affairs Palo Alto HealthCare System, Palo Alto, USA; Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, Stanford, CA, USA
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27
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Adamson MM, Taylor JL, Heraldez D, Khorasani A, Noda A, Hernandez B, Yesavage JA. Higher landing accuracy in expert pilots is associated with lower activity in the caudate nucleus. PLoS One 2014; 9:e112607. [PMID: 25426935 PMCID: PMC4245093 DOI: 10.1371/journal.pone.0112607] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2014] [Accepted: 10/09/2014] [Indexed: 11/19/2022] Open
Abstract
The most common lethal accidents in General Aviation are caused by improperly executed landing approaches in which a pilot descends below the minimum safe altitude without proper visual references. To understand how expertise might reduce such erroneous decision-making, we examined relevant neural processes in pilots performing a simulated landing approach inside a functional MRI scanner. Pilots (aged 20-66) were asked to "fly" a series of simulated "cockpit view" instrument landing scenarios in an MRI scanner. The scenarios were either high risk (heavy fog-legally unsafe to land) or low risk (medium fog-legally safe to land). Pilots with one of two levels of expertise participated: Moderate Expertise (Instrument Flight Rules pilots, n = 8) or High Expertise (Certified Instrument Flight Instructors or Air-Transport Pilots, n = 12). High Expertise pilots were more accurate than Moderate Expertise pilots in making a "land" versus "do not land" decision (CFII: d' = 3.62 ± 2.52; IFR: d' = 0.98 ± 1.04; p<.01). Brain activity in bilateral caudate nucleus was examined for main effects of expertise during a "land" versus "do not land" decision with the no-decision control condition modeled as baseline. In making landing decisions, High Expertise pilots showed lower activation in the bilateral caudate nucleus (0.97 ± 0.80) compared to Moderate Expertise pilots (1.91 ± 1.16) (p<.05). These findings provide evidence for increased "neural efficiency" in High Expertise pilots relative to Moderate Expertise pilots. During an instrument approach the pilot is engaged in detailed examination of flight instruments while monitoring certain visual references for making landing decisions. The caudate nucleus regulates saccade eye control of gaze, the brain area where the "expertise" effect was observed. These data provide evidence that performing "real world" aviation tasks in an fMRI provide objective data regarding the relative expertise of pilots and brain regions involved in it.
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Affiliation(s)
- Maheen M. Adamson
- Department of Veterans Affairs, WRIISC and Sierra-Pacific MIRECC, Palo Alto, California, 94304, United States of America
- Department of Psychiatry & Behavioral Sciences, Stanford School of Medicine, Stanford, California, 94305, United States of America
- * E-mail:
| | - Joy L. Taylor
- Department of Veterans Affairs, WRIISC and Sierra-Pacific MIRECC, Palo Alto, California, 94304, United States of America
- Department of Psychiatry & Behavioral Sciences, Stanford School of Medicine, Stanford, California, 94305, United States of America
| | - Daniel Heraldez
- Department of Psychiatry & Behavioral Sciences, Stanford School of Medicine, Stanford, California, 94305, United States of America
| | - Allen Khorasani
- Department of Psychiatry & Behavioral Sciences, Stanford School of Medicine, Stanford, California, 94305, United States of America
| | - Art Noda
- Department of Psychiatry & Behavioral Sciences, Stanford School of Medicine, Stanford, California, 94305, United States of America
| | - Beatriz Hernandez
- Department of Psychiatry & Behavioral Sciences, Stanford School of Medicine, Stanford, California, 94305, United States of America
| | - Jerome A. Yesavage
- Department of Veterans Affairs, WRIISC and Sierra-Pacific MIRECC, Palo Alto, California, 94304, United States of America
- Department of Psychiatry & Behavioral Sciences, Stanford School of Medicine, Stanford, California, 94305, United States of America
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Adamson MM, Main K, Kong JY, Soman S, Furst A, Kinoshita L, Yesavage J, Ashford JW. Integration of Clinical and Research Neuroimaging to Understand Traumatic Brain Injury in the Veteran Population. Fed Pract 2014; 31:3S-7S. [PMID: 26705383 PMCID: PMC4687744] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
There is a complex relationship between posttraumatic stress disorder and traumatic brain injury. To understand and treat these conditions, it is necessary to apply an integrated physical and mental health care approach to postdeployment care.
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Affiliation(s)
- Maheen M Adamson
- Dr. Adamson is deputy director of research and PhD fellowships for War Related Illness and Injury Study Center, California site (WRIISC CA), Ms. Kong is research assistant (WRIISC CA), Dr. Main is neuroscience postdoctoral research fellow (WRIISC CA), Dr. Soman is neuroradiologist and clinical neuroscience postdoctoral research fellow (WRIISC CA), Dr. Furst is associate director of neuroimaging laboratory (WRIISC CA), Dr. Kinoshita is Director VA Memory Clinic, Dr. Yesavage is associate chief of staff for mental health, and Dr. Ashford is director (WRIISC CA) at VA Palo Alto Health Care System, Palo Alto, California. Dr. Adamson is a clinical assistant professor at department of psychiatry & behavioral sciences (affiliated), Dr. Furst is clinical assistant professor at department of psychiatry & behavioral sciences and neurology (affiliated), Dr. Yesavage is professor of psychiatry and behavioral sciences, Dr. Ashford is clinical professor of psychiatry and behavioral sciences (affiliated) at Stanford University Medical Center, Stanford, California
| | - Keith Main
- Dr. Adamson is deputy director of research and PhD fellowships for War Related Illness and Injury Study Center, California site (WRIISC CA), Ms. Kong is research assistant (WRIISC CA), Dr. Main is neuroscience postdoctoral research fellow (WRIISC CA), Dr. Soman is neuroradiologist and clinical neuroscience postdoctoral research fellow (WRIISC CA), Dr. Furst is associate director of neuroimaging laboratory (WRIISC CA), Dr. Kinoshita is Director VA Memory Clinic, Dr. Yesavage is associate chief of staff for mental health, and Dr. Ashford is director (WRIISC CA) at VA Palo Alto Health Care System, Palo Alto, California. Dr. Adamson is a clinical assistant professor at department of psychiatry & behavioral sciences (affiliated), Dr. Furst is clinical assistant professor at department of psychiatry & behavioral sciences and neurology (affiliated), Dr. Yesavage is professor of psychiatry and behavioral sciences, Dr. Ashford is clinical professor of psychiatry and behavioral sciences (affiliated) at Stanford University Medical Center, Stanford, California
| | - Jennifer Y Kong
- Dr. Adamson is deputy director of research and PhD fellowships for War Related Illness and Injury Study Center, California site (WRIISC CA), Ms. Kong is research assistant (WRIISC CA), Dr. Main is neuroscience postdoctoral research fellow (WRIISC CA), Dr. Soman is neuroradiologist and clinical neuroscience postdoctoral research fellow (WRIISC CA), Dr. Furst is associate director of neuroimaging laboratory (WRIISC CA), Dr. Kinoshita is Director VA Memory Clinic, Dr. Yesavage is associate chief of staff for mental health, and Dr. Ashford is director (WRIISC CA) at VA Palo Alto Health Care System, Palo Alto, California. Dr. Adamson is a clinical assistant professor at department of psychiatry & behavioral sciences (affiliated), Dr. Furst is clinical assistant professor at department of psychiatry & behavioral sciences and neurology (affiliated), Dr. Yesavage is professor of psychiatry and behavioral sciences, Dr. Ashford is clinical professor of psychiatry and behavioral sciences (affiliated) at Stanford University Medical Center, Stanford, California
| | - Salil Soman
- Dr. Adamson is deputy director of research and PhD fellowships for War Related Illness and Injury Study Center, California site (WRIISC CA), Ms. Kong is research assistant (WRIISC CA), Dr. Main is neuroscience postdoctoral research fellow (WRIISC CA), Dr. Soman is neuroradiologist and clinical neuroscience postdoctoral research fellow (WRIISC CA), Dr. Furst is associate director of neuroimaging laboratory (WRIISC CA), Dr. Kinoshita is Director VA Memory Clinic, Dr. Yesavage is associate chief of staff for mental health, and Dr. Ashford is director (WRIISC CA) at VA Palo Alto Health Care System, Palo Alto, California. Dr. Adamson is a clinical assistant professor at department of psychiatry & behavioral sciences (affiliated), Dr. Furst is clinical assistant professor at department of psychiatry & behavioral sciences and neurology (affiliated), Dr. Yesavage is professor of psychiatry and behavioral sciences, Dr. Ashford is clinical professor of psychiatry and behavioral sciences (affiliated) at Stanford University Medical Center, Stanford, California
| | - Ansgar Furst
- Dr. Adamson is deputy director of research and PhD fellowships for War Related Illness and Injury Study Center, California site (WRIISC CA), Ms. Kong is research assistant (WRIISC CA), Dr. Main is neuroscience postdoctoral research fellow (WRIISC CA), Dr. Soman is neuroradiologist and clinical neuroscience postdoctoral research fellow (WRIISC CA), Dr. Furst is associate director of neuroimaging laboratory (WRIISC CA), Dr. Kinoshita is Director VA Memory Clinic, Dr. Yesavage is associate chief of staff for mental health, and Dr. Ashford is director (WRIISC CA) at VA Palo Alto Health Care System, Palo Alto, California. Dr. Adamson is a clinical assistant professor at department of psychiatry & behavioral sciences (affiliated), Dr. Furst is clinical assistant professor at department of psychiatry & behavioral sciences and neurology (affiliated), Dr. Yesavage is professor of psychiatry and behavioral sciences, Dr. Ashford is clinical professor of psychiatry and behavioral sciences (affiliated) at Stanford University Medical Center, Stanford, California
| | - Lisa Kinoshita
- Dr. Adamson is deputy director of research and PhD fellowships for War Related Illness and Injury Study Center, California site (WRIISC CA), Ms. Kong is research assistant (WRIISC CA), Dr. Main is neuroscience postdoctoral research fellow (WRIISC CA), Dr. Soman is neuroradiologist and clinical neuroscience postdoctoral research fellow (WRIISC CA), Dr. Furst is associate director of neuroimaging laboratory (WRIISC CA), Dr. Kinoshita is Director VA Memory Clinic, Dr. Yesavage is associate chief of staff for mental health, and Dr. Ashford is director (WRIISC CA) at VA Palo Alto Health Care System, Palo Alto, California. Dr. Adamson is a clinical assistant professor at department of psychiatry & behavioral sciences (affiliated), Dr. Furst is clinical assistant professor at department of psychiatry & behavioral sciences and neurology (affiliated), Dr. Yesavage is professor of psychiatry and behavioral sciences, Dr. Ashford is clinical professor of psychiatry and behavioral sciences (affiliated) at Stanford University Medical Center, Stanford, California
| | - Jerome Yesavage
- Dr. Adamson is deputy director of research and PhD fellowships for War Related Illness and Injury Study Center, California site (WRIISC CA), Ms. Kong is research assistant (WRIISC CA), Dr. Main is neuroscience postdoctoral research fellow (WRIISC CA), Dr. Soman is neuroradiologist and clinical neuroscience postdoctoral research fellow (WRIISC CA), Dr. Furst is associate director of neuroimaging laboratory (WRIISC CA), Dr. Kinoshita is Director VA Memory Clinic, Dr. Yesavage is associate chief of staff for mental health, and Dr. Ashford is director (WRIISC CA) at VA Palo Alto Health Care System, Palo Alto, California. Dr. Adamson is a clinical assistant professor at department of psychiatry & behavioral sciences (affiliated), Dr. Furst is clinical assistant professor at department of psychiatry & behavioral sciences and neurology (affiliated), Dr. Yesavage is professor of psychiatry and behavioral sciences, Dr. Ashford is clinical professor of psychiatry and behavioral sciences (affiliated) at Stanford University Medical Center, Stanford, California
| | - J Wesson Ashford
- Dr. Adamson is deputy director of research and PhD fellowships for War Related Illness and Injury Study Center, California site (WRIISC CA), Ms. Kong is research assistant (WRIISC CA), Dr. Main is neuroscience postdoctoral research fellow (WRIISC CA), Dr. Soman is neuroradiologist and clinical neuroscience postdoctoral research fellow (WRIISC CA), Dr. Furst is associate director of neuroimaging laboratory (WRIISC CA), Dr. Kinoshita is Director VA Memory Clinic, Dr. Yesavage is associate chief of staff for mental health, and Dr. Ashford is director (WRIISC CA) at VA Palo Alto Health Care System, Palo Alto, California. Dr. Adamson is a clinical assistant professor at department of psychiatry & behavioral sciences (affiliated), Dr. Furst is clinical assistant professor at department of psychiatry & behavioral sciences and neurology (affiliated), Dr. Yesavage is professor of psychiatry and behavioral sciences, Dr. Ashford is clinical professor of psychiatry and behavioral sciences (affiliated) at Stanford University Medical Center, Stanford, California
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Taylor JL, Scanlon BK, Farrell M, Hernandez B, Adamson MM, Ashford JW, Noda A, Murphy GM, Weiner MW. APOE-epsilon4 and aging of medial temporal lobe gray matter in healthy adults older than 50 years. Neurobiol Aging 2014; 35:2479-2485. [PMID: 24929969 DOI: 10.1016/j.neurobiolaging.2014.05.011] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2013] [Revised: 04/23/2014] [Accepted: 05/11/2014] [Indexed: 12/31/2022]
Abstract
Atrophy of the hippocampus and surrounding temporal regions occurs in Alzheimer's disease (AD). APOE ε4, the major genetic risk factor for late-onset AD, has been associated with smaller volume in these regions before amyloidosis can be detected by AD biomarkers. To examine APOE ε4 effects in relation to aging, we performed a longitudinal magnetic resonance imaging study involving cognitively normal adults (25 APOE ε4 carriers and 31 ε3 homozygotes), initially aged 51-75 years. We used growth curve analyses, which can provide information about APOE ε4-related differences initially and later in life. Hippocampal volume was the primary outcome; nearby medial temporal regions were secondary outcomes. Brain-derived neurotrophic factor, val66met was a secondary covariate. APOE ε4 carriers had significantly smaller initial hippocampal volumes than ε3 homozygotes. Rate of hippocampal atrophy was not greater in the APOE ε4 group, although age-related atrophy was detected in the overall sample. The findings add to the growing evidence that effects of APOE ε4 on hippocampal size begin early in life, underscoring the importance of early interventions to increase reserve.
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Affiliation(s)
- Joy L Taylor
- Veterans Affairs Palo Alto Health Care System, Sierra-Pacific MIRECC, Palo Alto CA, USA; Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, Stanford, CA, USA.
| | - Blake K Scanlon
- Veterans Affairs Palo Alto Health Care System, Sierra-Pacific MIRECC, Palo Alto CA, USA; Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, Stanford, CA, USA
| | - Michelle Farrell
- Veterans Affairs Palo Alto Health Care System, Sierra-Pacific MIRECC, Palo Alto CA, USA; Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, Stanford, CA, USA
| | - Beatriz Hernandez
- Veterans Affairs Palo Alto Health Care System, Sierra-Pacific MIRECC, Palo Alto CA, USA; Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, Stanford, CA, USA
| | - Maheen M Adamson
- Veterans Affairs Palo Alto Health Care System, Sierra-Pacific MIRECC, Palo Alto CA, USA; Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, Stanford, CA, USA
| | - J Wesson Ashford
- Veterans Affairs Palo Alto Health Care System, Sierra-Pacific MIRECC, Palo Alto CA, USA; Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, Stanford, CA, USA
| | - Art Noda
- Veterans Affairs Palo Alto Health Care System, Sierra-Pacific MIRECC, Palo Alto CA, USA; Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, Stanford, CA, USA
| | - Greer M Murphy
- Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, Stanford, CA, USA
| | - Michael W Weiner
- Department of Veterans Affairs Medical Center, Center for Imaging of Neurodegenerative Diseases, San Francisco, CA, USA; Department of Radiology, University of California, San Francisco, CA, USA
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Bayley PJ, Isaac L, Kong JY, Adamson MM, Ashford JW, Mahoney LA, Beltran M, Brown-Elhillali A, Held A, Ajayi A, Belcher H, Bond A, Mason H, Lemaster C, Shaw S, Mullin C, Holick E, Saper R, Braun TD, Riley KE, Park CL, Trehern AE, Davis MB, Mastronardi EL, Butzer B, Khalsa SBS, Shorter SM, Reinhardt KM, Cope S, Cheung C, Justice C, Wyman J, Cook-Cottone CP, Daly LA, Haden SC, Hagins M, Danhauer SC, Griffin LP, Avis NE, Sohl SJ, Lawrence J, Jesse MT, Addington EL, Messino MJ, Giguere JK, Lucas SL, Wiliford SK, Shaw E, de Manincor M, Bensoussan A, Smith C, Fahey P, Bourchier S, Desrochers DIM, Viswanathan S, Partharasathy BR, Doherty K, Moye J, Walsh C, Pokaski-Azar J, Gosian J, Chapman J, King K, Sohl S, Danhauer S, Dunbar E, Gabriel MG, Huebner M, Hofmann SG, Khalsa SBS, Gaskins RB, Jennings E, Thind H, Fava JL, Hartman S, Bock BC, Gramann P, Haaz S, Bingham CO, Bartlett SJ, Hagins M, States R, Selfe T, Innes K, Harris AR, Jennings PA, Abenavoli RM, Katz DA, Hudecek KM, Greenberg MT, Jeter PE, Nkodo AF, Haaz S, Dagnelie G, Keosaian JE, Lemaster CM, Chao M, Saper RB, King KD, Gosian J, Doherty K, Walsh C, Pokaski Azar J, Chapman J, Danhauer SC, Moye J, Kinser P, Bourguignon C, Taylor A, Mahoney LA, Bayley PJ, Collery LM, Menzies-Toman D, Nilsson M, Frykman V, Noggle JJ, Braun T, Khalsa SBS, Nosaka M, Okamura H, Fukatu N, Potts A, Weidknecht K, Coulombe S, Davies B, Ryan C, Day D, Reale J, Staples JK, Knoefel J, Herman C, Riley KE, Park CL, Bedesin EY, Stewart VM, Riley KE, Braun TD, Park CL, Pescatello LS, Davis MB, Trehern AE, Mastronardi EL, Rioux J, Rosen RK, Thind H, Gaskins R, Jennings E, Morrow K, Williams D, Bock B, Rousseau D, Jackson E, Schmid AA, Miller KK, Van Puymbroeck M, Debaun EL, Schalk N, Dierks TD, Altenburger P, Damush T, Williams LS, Selman L, Citron T, Howie-Esquivel J, McDermott K, Milic M, Donesky D, Shook A, Ruzic R, Galloway F, Van Puymbroeck M, Miller KK, Schalk N, Schmid AA, Ward LJ, Stebbings S, Sherman K, Cherkin D, Baxter GD, West JI, Duffy N, Liang B. 2013 SYR Accepted Poster Abstracts. Int J Yoga Therap 2013; 23:32-53. [PMID: 24016822] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
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Adamson MM, Bayley PJ, Scanlon BK, Farrell ME, Hernandez B, Weiner MW, Yesavage JA, Taylor JL. Pilot expertise and hippocampal size: associations with longitudinal flight simulator performance. ACTA ACUST UNITED AC 2012; 83:850-7. [PMID: 22946348 DOI: 10.3357/asem.3215.2012] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
BACKGROUND Previous research suggests that the size of the hippocampus can vary in response to intensive training (e.g., during the acquisition of expert knowledge). However, the role of the hippocampus in maintenance of skilled performance is not well understood. The Stanford/Veterans Affairs Aviation MRI Study offers a unique opportunity to observe the interaction of brain structure and multiple levels of expertise on longitudinal flight simulator performance. METHODS The current study examined the relationship between hippocampal volume and three levels of aviation expertise, defined by pilot proficiency ratings issued by the U.S. Federal Aviation Administration (11). At 3 annual time points, 60 pilots who varied in their level of aviation expertise (ages ranging from 45 to 69 yr) were tested. RESULTS At baseline, higher expertise was associated with better flight simulator performance, but not with hippocampal volume. Longitudinally, there was an Expertise x Hippocampal volume interaction, in the direction that a larger hippocampus was associated with better performance at higher levels of expertise. DISCUSSION These results are consistent with the notion that expertise in a cognitively demanding domain involves the interplay of acquired knowledge ('mental schemas') and basic hippocampal-dependent processes.
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Affiliation(s)
- Maheen M Adamson
- War Related Illness and Injury Study Center and the Sierra-Pacific MIRECC, Veterans Affairs, Palo Alto Health Care System, Palo Alto, CA 94304, USA.
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Adamson MM. Commentary on "Abnormalities of the Fornix in Mild Cognitive Impairment are Related to Episodic Memory Loss". J Alzheimers Dis 2012; 31:677-8. [PMID: 22796870 DOI: 10.3233/jad-2012-111767] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Affiliation(s)
- Maheen M Adamson
- Department of Veterans Affairs, Sierra-Pacific MIRECC, and WRIISC, Palo Alto, CA, USA.
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Taylor JL, Kennedy Q, Adamson MM, Lazzeroni LC, Noda A, Murphy GM, Yesavage JA. Influences of APOE ε4 and expertise on performance of older pilots. Psychol Aging 2011; 26:480-7. [PMID: 21668123 DOI: 10.1037/a0021697] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Little is known about how APOE ε4-related differences in cognitive performance translate to real-life performance, where training and experience may help to sustain performance. We investigated the influences of APOE ε4 status, expertise (FAA pilot proficiency ratings), and their interaction on longitudinal flight simulator performance. Over a 2-year period, 139 pilots aged 42-69 years were tested annually. APOE ε4 carriers had lower memory performance than noncarriers (p = .019). APOE interacted with Expertise (p = .036), such that the beneficial influence of expertise (p = .013) on longitudinal flight simulator performance was more pronounced for ε4 carriers. Results suggest that relevant training and activity may help sustain middle-aged and older adults' real-world performance, especially among APOE ε4 carriers.
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Affiliation(s)
- Joy L Taylor
- Psychiatry Service, Department of Veterans Affairs, Palo Alto Health Care System. Palo Alto, CA 94304-1207, USA.
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Adamson MM, Hutchinson JB, Shelton AL, Wagner AD, Taylor JL. Reduced hippocampal activity during encoding in cognitively normal adults carrying the APOE ɛ4 allele. Neuropsychologia 2011; 49:2448-55. [PMID: 21549723 PMCID: PMC3137687 DOI: 10.1016/j.neuropsychologia.2011.04.022] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2010] [Revised: 04/11/2011] [Accepted: 04/17/2011] [Indexed: 01/11/2023]
Abstract
Apolipoprotein (APOE) ɛ4-related differences in memory performance have been detected before age 65. The hippocampus and the surrounding medial temporal lobe (MTL) structures are the first site affected by Alzheimer's disease (AD) and the MTL is the seat of episodic memory, including visuo-spatial memory. While reports of APOE ɛ4-related differences in these brain structures are not consistent in either cross-sectional or longitudinal structural and functional magnetic resonance imaging (fMRI) studies, there is increasing evidence that brain activity at baseline (defined as activity during fixation or rest) may differ in APOE ɛ4 carriers compared to non-carriers. In this fMRI study, cognitively normal APOE ɛ4 carriers and non-carriers engaged in a perspective-dependent spatial learning task (Shelton & Gabrieli, 2002) previously shown to activate MTL structures in older participants (Borghesani et al., 2008). A low-level, visually engaging dot-control task was used for comparison, in addition to fixation. APOE ɛ4 carriers showed less activation than non-carriers in the hippocampus proper during encoding. Specifically, when spatial encoding was contrasted against the dot-control task, encoding-related activation was significantly lower in carriers than non-carriers. By contrast, no ɛ4-related differences in the hippocampus were found when spatial encoding was compared with fixation. Lower activation, however, was not global since encoding-related activation in early visual cortex (left lingual gyrus) was not different between APOE ɛ4 carriers and non-carriers. The present data document APOE ɛ4-related differences in the hippocampus proper during encoding and underscore the role of low-level control contrasts for complex encoding tasks. These results have implications for fMRI studies that investigate the default-mode network (DMN) in middle-aged to older APOE ɛ4 carriers to help evaluate AD risk in this otherwise cognitively normal population.
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Affiliation(s)
- Maheen M Adamson
- Department of Veterans Affairs, Sierra-Pacific MIRECC and WRIISC Palo Alto, CA, USA.
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Yesavage JA, Jo B, Adamson MM, Kennedy Q, Noda A, Hernandez B, Zeitzer JM, Friedman LF, Fairchild K, Scanlon BK, Murphy GM, Taylor JL. Initial cognitive performance predicts longitudinal aviator performance. J Gerontol B Psychol Sci Soc Sci 2011; 66:444-53. [PMID: 21586627 DOI: 10.1093/geronb/gbr031] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
OBJECTIVES The goal of the study was to improve prediction of longitudinal flight simulator performance by studying cognitive factors that may moderate the influence of chronological age. METHOD We examined age-related change in aviation performance in aircraft pilots in relation to baseline cognitive ability measures and aviation expertise. Participants were aircraft pilots (N = 276) aged 40-77.9. Flight simulator performance and cognition were tested yearly; there were an average of 4.3 (± 2.7; range 1-13) data points per participant. Each participant was classified into one of the three levels of aviation expertise based on Federal Aviation Administration pilot proficiency ratings: least, moderate, or high expertise. RESULTS Addition of measures of cognitive processing speed and executive function to a model of age-related change in aviation performance significantly improved the model. Processing speed and executive function performance interacted such that the slowest rate of decline in flight simulator performance was found in aviators with the highest scores on tests of these abilities. Expertise was beneficial to pilots across the age range studied; however, expertise did not show evidence of reducing the effect of age. DISCUSSION These data suggest that longitudinal performance on an important real-world activity can be predicted by initial assessment of relevant cognitive abilities.
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Affiliation(s)
- Jerome A Yesavage
- Stanford/VA Aging Clinical Research Center, VA Palo Alto Health Care System, Palo Alto, CA 94304-1207, USA.
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Ashford JW, Salehi A, Furst A, Bayley P, Frisoni GB, Jack CR, Sabri O, Adamson MM, Coburn KL, Olichney J, Schuff N, Spielman D, Edland SD, Black S, Rosen A, Kennedy D, Weiner M, Perry G. Imaging the Alzheimer brain. J Alzheimers Dis 2011; 26 Suppl 3:1-27. [PMID: 21971448 PMCID: PMC3760773 DOI: 10.3233/jad-2011-0073] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
This supplement to the Journal of Alzheimer's Disease contains more than half of the chapters from The Handbook of Imaging the Alzheimer Brain, which was first presented at the International Conference on Alzheimer's Disease in Paris, in July, 2011. While the Handbook contains 27 chapters that are modified articles from 2009, 2010, and 2011 issues of the Journal of Alzheimer's Disease, this supplement contains the 31 new chapters of that book and an introductory article drawn from the introductions to each section of the book. The Handbook was designed to provide a multilevel overview of the full field of brain imaging related to Alzheimer's disease (AD). The Handbook, as well as this supplement, contains both reviews of the basic concepts of imaging, the latest developments in imaging, and various discussions and perspectives of the problems of the field and promising directions. The Handbook was designed to be useful for students and clinicians interested in AD as well as scientists studying the brain and pathology related to AD.
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Halbauer JD, Ashford JW, Zeitzer JM, Adamson MM, Lew HL, Yesavage JA. Neuropsychiatric diagnosis and management of chronic sequelae of war-related mild to moderate traumatic brain injury. ACTA ACUST UNITED AC 2010; 46:757-96. [PMID: 20104402 DOI: 10.1682/jrrd.2008.08.0119] [Citation(s) in RCA: 80] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Soldiers with a traumatic brain injury (TBI) present with an array of neuropsychiatric symptoms that can be grouped into nosological clusters: (1) cognitive dysfunctions: difficulties in memory, attention, language, visuospatial cognition, sensory-motor integration, affect recognition, and/or executive function typically associated with neocortical damage; (2) neurobehavioral disorders: mood, affect, anxiety, posttraumatic stress, and psychosis, as well as agitation, sleep problems, and libido loss, that may have been caused by damage to the cortex, limbic system, and/or brain stem monoaminergic projection systems; (3) somatosensory disruptions: impaired smell, vision, hearing, equilibrium, taste, and somatosensory perception frequently caused by trauma to the sensory organs or their projections through the brain stem to central processing systems; (4) somatic symptoms: headache and chronic pain; and (5) substance dependence. TBI-related cognitive impairment is common in veterans who have served in recent conflicts in the Middle East and is often related to blasts from improvised explosive devices. Although neurobehavioral disorders such as depression and posttraumatic stress disorder commonly occur after combat, the presentation of such disorders in those with head injury may pass undetected with use of current diagnostic criteria and neuropsychological instruments. With a multidimensional approach (such as the biopsychosocial model) applied to each symptom cluster, psychological, occupational, and social dysfunction can be delineated and managed.
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Affiliation(s)
- Joshua D Halbauer
- Department of Veterans Affairs (VA) Palo Alto Health Care System, Palo Alto, CA 94304, USA
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Adamson MM, Ortega M, Samarina V, Huynh V, Cardenas-Nicholson V, Taylor JL. Examining Expert Knowledge and General Cognitive Ability in Pilots: A Preliminary Voxel Based Morphometry Study. Neuroimage 2009. [DOI: 10.1016/s1053-8119(09)71139-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022] Open
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Adamson MM, Landy KM, Duong S, Fox-Bosetti S, Ashford JW, Murphy GM, Weiner M, Taylor JL. Apolipoprotein E epsilon4 influences on episodic recall and brain structures in aging pilots. Neurobiol Aging 2008; 31:1059-63. [PMID: 18760504 DOI: 10.1016/j.neurobiolaging.2008.07.017] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2008] [Revised: 06/28/2008] [Accepted: 07/23/2008] [Indexed: 10/21/2022]
Abstract
The apolipoprotein (APOE) epsilon4 allele is associated with cognitive deficits and hippocampal atrophy in nondemented middle-aged and older adults. It is not known to what extent this genetic risk factor for Alzheimer's disease (AD) impacts performance in late middle-aged and older workers in cognitively demanding occupations. This cross-sectional analysis examines brain-cognitive-genetic relationships in actively flying general aviation pilots, half of whom are APOE epsilon4 carriers. Fifty pilots were studied with structural MRI and memory tasks. Average visual paired associate memory recall performance was lower in APOE epsilon4 carriers than non-carriers. Memory performance correlated positively with hippocampal volume, but no structural differences were found in hippocampal or frontal volumes with respect to APOE epsilon4 allele. These results were evident in healthy professionals without any presenting memory problems and without selection for a family history of AD. These findings point to basic memory testing as a sensitive tool for detecting APOE epsilon4-related influences on memory in aging workers.
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Hellige JB, Adamson MM. Hemispheric differences in processing handwritten cursive. Brain Lang 2007; 102:215-27. [PMID: 17157906 DOI: 10.1016/j.bandl.2006.11.003] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/24/2006] [Revised: 09/16/2006] [Accepted: 11/07/2006] [Indexed: 05/12/2023]
Abstract
Hemispheric asymmetry was examined for native English speakers identifying consonant-vowel-consonant (CVC) non-words presented in standard printed form, in standard handwritten cursive form or in handwritten cursive with the letters separated by small gaps. For all three conditions, fewer errors occurred when stimuli were presented to the right visual field/left hemisphere (RVF/LH) than to the left visual field/right hemisphere (LVF/RH) and qualitative error patterns indicated that the last letter was missed more often than the first letter on LVF/RH trials but not on RVF/LH trials. Despite this overall similarity, the RVF/LH advantage was smaller for both types of cursive stimuli than for printed stimuli. In addition, the difference between first-letter and last-letter errors was smaller for handwritten cursive than for printed text, especially on LVF/RH trials. These results suggest a greater contribution of the right hemisphere to the identification of handwritten cursive, which is likely related visual complexity and to qualitative differences in the processing of cursive versus print.
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Affiliation(s)
- Joseph B Hellige
- Department of Psychology, University of Southern California, Los Angeles, CA 90089-1061, USA.
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Hamdan MH, Zagrodzky JD, Page RL, Wasmund SL, Sheehan CJ, Adamson MM, Joglar JA, Smith ML. Effect of P-wave timing during supraventricular tachycardia on the hemodynamic and sympathetic neural response. Circulation 2001; 103:96-101. [PMID: 11136692 DOI: 10.1161/01.cir.103.1.96] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
BACKGROUND Previous studies have shown the importance of the timing of atrial and ventricular systole on the hemodynamic response during supraventricular tachycardia (SVT). However, the reflex changes in autonomic tone during SVT remain poorly understood. METHODS AND RESULTS Eleven patients with permanent dual-chamber pacemakers were enrolled in the study. Arterial blood pressure (BP), central venous pressure (CVP), and peripheral muscle sympathetic nerve activity (SNA) were recorded during DDD pacing at a rate of 175 bpm (cycle length 343 ms) with an atrioventricular (AV) interval of 30, 200 and 110 ms, simulating tachycardia with near-simultaneous atrial and ventricular systole, short-RP tachycardia (RP<PR), and long-RP tachycardia (RP>PR). Each pacing run was performed for 3 minutes separated by a 5-minute recovery period. All patients demonstrated an abrupt fall in BP, an increase in CVP, and an increase in SNA regardless of the AV interval. The decreases in SBP, DBP, and MAP and the increase in CVP were significantly less during long-RP tachycardia (AV interval 110 ms) than during the other 2 pacing modes (P:<0.05), and the increase in SNA in 7 of the 11 patients was significantly greater during closely coupled atrial and ventricular systole than during long-RP tachycardia (P:<0.05). CONCLUSIONS These data suggest that the superior maintenance of hemodynamic stability during long-RP tachycardia is accompanied by reduced sympathoexcitation, which is primarily mediated by the arterial baroreceptors, with a modest cardiopulmonary vasodepressor effect.
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Affiliation(s)
- M H Hamdan
- University of Texas Southwestern Medical Center and Dallas Veterans Affairs Medical Center, Dallas, TX 75216, USA.
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Hamdan MH, Page RL, Wasmund SL, Sheehan CJ, Zagrodzky JD, Ramaswamy K, Joglar JA, Adamson MM, Barron BA, Smith ML. Selective parasympathetic denervation following posteroseptal ablation for either atrioventricular nodal reentrant tachycardia or accessory pathways. Am J Cardiol 2000; 85:875-8, A9. [PMID: 10758931 DOI: 10.1016/s0002-9149(99)00885-1] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/16/2022]
Abstract
Baroreflex gain and coronary sinus norepinephrine and epinephrine levels were measured before and immediately after radiofrequency ablation in the posteroseptal region in 9 patients with atrioventricular nodal reentrant tachycardia or posteroseptal accessory pathways. Arterial baroreflex gain was significantly reduced after radiofrequency ablation (p = 0.046), whereas coronary sinus epinephrine and norepinephrine levels did not change significantly compared with preablation levels.
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Affiliation(s)
- M H Hamdan
- University of Texas Southwestern Medical Center and Dallas Veterans Affairs Medical Center, Division of Cardiology, 75216, USA.
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